Three-times daily radiotherapy after chemotherapy in stage III non-small cell lung cancer. Single-institution prospective study.
OBJECTIVE
A prospective study for stage IIIA-B nonsmall cell lung cancer (NSCLC), with three-times daily (3td) radiotherapy (RT), after induction chemotherapy (iCT), with or without surgery.


METHODS
Induction cisplatin and gemcitabine chemotherapy was delivered. Surgery and postoperative (post-op) radiotherapy were planned for responsive stage IIIA patients; definitive irradiation was performed in unresectable IIIA and IIIB patients. Doses of 54.4 and 64.6 Gy were delivered for the post-op and definitive treatments, respectively.


RESULTS
Out of 52 patients (pts), 37 received 3tdRT as definitive (18 pts) or post-op treatment (19 pts). Overall, the failures were similar between post-op and definitive 3tdRT (78.9% vs. 77.8%). In the post-op treatment, metastases and local failures were 52.6% and 10.5%, respectively and in the definitive radiotherapy, the incidence was similar (local 33.3% vs. systemic 44.4%). The five-year overall survival (OS) was 25% for the post-op and 21% for the definitive patients (p = 0.87).


CONCLUSIONS
Three-times daily postoperative radiotherapy did not improve the outcome in NSCLC, but for unresectable patients, this approach may have a role in selected cases.
Catalano
Gianpiero
G
Division of Radiotherapy, European Institute of Oncology, Milan, Italy. gianpiero.catalano@ieo.it
De Pas
Tommaso
T
Spaggiari
Lorenzo
L
Gandini
Sara
S
Jereczek-Fossa
Barbara Alicja
BA
De Braud
Filippo
F
Leo
Francesco
F
Veronesi
Giulia
G
Orecchia
Roberto
R
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D008297:Male; D008479:Mediastinal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000556:secondary; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D015996:Survival Rate