title: Radiotherapy alone vs. radiochemotherapy in patients with favorable prognosis of clinical stage IIIA non-small-cell lung cancer.
abstract: OBJECTIVE
  To evaluate the outcome of radiotherapy (RT) vs. radiochemotherapy (RT-CHT) in patients with locally advanced, inoperable non-small-cell lung cancer who had a "favorable" prognosis (stage IIIA, Karnofsky performance score 70-100, no weight loss >5%).
  
  
  METHODS
  A total of 222 patients with these characteristics were among 600 patients enrolled into 5 prospective trials between 1988 and 1998, and were treated with either hyperfractionated RT alone (doses of 69.6 and 67.6 Gy when using 1.2 and 1.3 Gy twice a day, respectively) (n = 45) or the same hyperfractionated RT and concurrent CHT (n = 177), which consists of either carboplatin-etoposide (or paclitaxel-carboplatin.
  
  
  RESULTS
  The median times and 5-year overall survival, local progression-free survival, and the distant metastasis-free survival rates for all 222 patients were 33 months, 31 months, and not attained yet, respectively, and 36%, 43%, and 57%, respectively. RT-CHT was superior to RT alone in terms of both overall survival (median survival time, 38 vs. 21 months, respectively; 5-year, 41% vs. 16%, respectively; P < .001) and local progression-free survival (median time to local progression, 38 vs. 22 months, respectively, 5-year local progression-free survival, 48% vs. 23%, respectively; P < .001) but not the distant metastasis-free survival. The most frequent acute high-grade (>3) toxicity was esophageal and bronchopulmonary (8% each) and the most frequent late high-grade toxicity was esophageal (6%). RT-CHT caused only significantly more hematologic high-grade toxicity.
  
  
  CONCLUSIONS
  RT-CHT achieved excellent results in this favorable patient population (median survival time, 38 months; 5-year survival, 41%) accompanied with very low toxicity. These results compare favorably with results of other similar studies when using combined RT and CHT, with or without surgery.
authors.affiliation: Department of Oncology, University Hospital, Kragujevac, Serbia. b.jeremic@sun.ac.za
authors.forename: Branislav
authors.initials: B
authors.lastname: Jeremić
authors.forename: Biljana
authors.initials: B
authors.lastname: Miličić
authors.forename: Slobodan
authors.initials: S
authors.lastname: Milisavljević
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies