title: [Concurrent chemoradiotherapy followed by consolidation chemotherapy and sequential chemoradiotherapy for stage III non-small cell lung cancer: comparison in 93 patients].
abstract: OBJECTIVE
  To compare the efficacy and toxicity of concurrent chemoradiotherapy followed by consolidation chemotherapy (CCRT-CT) and sequential chemoradiotherapy (SCRT) in the treatment of stage III non-small cell lung cancer.
  
  
  METHODS
  From February, 2007 to June, 2010, 93 patients with unresectable stage III non-small cell lung cancer were treated with SCRT or CCRT-CT. SCRT group (50 cases) received radiotherapy after 2-6 cycles of chemotherapy (median 2 cycles) followed by 0-4 cycles (median 2 cycles) of chemotherapy. CCRT-CT group (43 cases) received 2 cycles of chemotherapy every 3 weeks with concurrent radiotherapy followed by 2-4 cycles (median 2 cycles) of chemotherapy with the same drugs. The chemotherapy consisted of cisplatin plus gemcitabine, docetaxel or vinorelbine. Radiotherapy was administered using two-dimensional conformal irradiation (36-40 Gy/18-20f) followed by three-dimensional conformal boost to 56-70 Gy/28-35f (median DT64Gy) or using three-dimensional conformal irradiation 50-74 Gy/25-37f (median DT62Gy).
  
  
  RESULTS
  The response rates were 76.7% and 54.0% in CCRT-CT and SCRT group, respectively (P<0.05). The median progression-free time in the two groups was 16.0 and 10.0 months, with the overall survival time of 18.0 and 12.5 months, respectively. The 1-, 2- and 3-year overall survival rates were 83.7%, 48.8% and 20.9% in CCRT-CT group and 52.0%, 20.0%, and 2.0% in SCRT group, respectively (P<0.05). CCRT-CT group showed a significantly lower rate of distant metastasis than SCRT group (P<0.05), but the local recurrence rate was similar between the two groups. The main side effects included radiation pneumonitis, radiation esophagitis, nausea/vomiting and anemia/leucopenia/thrombocytopenia. CCRT-CT group had a significantly higher rate of III-IV grade nausea/vomiting and anemia/leucopenia/thrombocytopenia than SCRT group.
  
  
  CONCLUSIONS
  Compared to SCRT, CCRT-CT can improve the response rate, progression free survival and overall survival and decrease the rate of distant metastasis, but is associated with a higher toxicity.
authors.affiliation: Department of Radiation Oncology, First Affiliated Hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710061, China. swz032021511986@163.com
authors.forename: Wen-Ze
authors.initials: WZ
authors.lastname: Sun
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Song
authors.forename: Ying-Bing
authors.initials: YB
authors.lastname: Zhang
authors.forename: Ting
authors.initials: T
authors.lastname: Ai
authors.forename: Jin-Li
authors.initials: JL
authors.lastname: Lu
authors.forename: Juan
authors.initials: J
authors.lastname: Ren
authors.forename: Ying
authors.initials: Y
authors.lastname: Gao
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D003131:Combined Modality Therapy; D060830:Consolidation Chemotherapy / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016019:Survival Analysis