title: A pilot study of conformal radiotherapy combined with erlotinib-based multimodality therapy in newly diagnosed metastatic non-small-cell lung cancer.
abstract: OBJECTIVE
  Lung cancer is the leading cause of cancer-related death in the world, particularly in major cities in China. We aimed to determine the benefit of survival and toxicity of Conformal Radiotherapy (CRT) combined with erlotinib-based multimodality therapy in newly diagnosed metastatic non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  Newly diagnosed metastatic NSCLC patients were treated with CRT and erlotinib, with or without chemotherapy matched protocol. The patients received CRT with a dose of 30-66 Gy. Erlotinib was used at least one 28-day cycle. The primary end point was overall survival (OS).
  
  
  RESULTS
  Thirty-two patients were analyzed. The median OS was 517 days. Patients with only one metastasis showed longer survival than patients with multi-metastases (986 vs. 380 days, n = 8 vs. 24, p = .009). Patients with multiple metastases in brain conferred worse survival for patients without and with sole brain metastasis (321 vs. 700 days, n=11 vs 21, p = .006). There was no significant difference in median survival whether erlotinib was used as a first-, second- or third-line therapy (380 vs. 700 vs. 310 days, n = 10 vs. 15 vs 7, respectively. p = .179). Patients with TTCRT > 90 days had longer OS than patients with TTCRT ≤ 90 days (749 vs. 322 days, n = 11 vs. 21, p = .012). Patients tolerated treatment with limited Grade 1/2 toxicity.
  
  
  CONCLUSIONS
  In this study, patients with newly diagnosed metastatic NSCLC had survival benefits when erlotinib was used combined with CRT. Further prospective trials are needed to derive maximal benefit from the drug treatment.
authors.affiliation: Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China. chenlh5461@163.com.
authors.forename: L
authors.initials: L
authors.lastname: Li
authors.forename: L-Y
authors.initials: LY
authors.lastname: Liu
authors.forename: M
authors.initials: M
authors.lastname: Chen
authors.forename: N-J
authors.initials: NJ
authors.lastname: Xiao
authors.forename: Y-W
authors.initials: YW
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Zhang
authors.forename: Q-Y
authors.initials: QY
authors.lastname: Li
authors.forename: Q-S
authors.initials: QS
authors.lastname: Li
authors.forename: Y-M
authors.initials: YM
authors.lastname: Dai
authors.forename: M
authors.initials: M
authors.lastname: Yang
authors.forename: C
authors.initials: C
authors.lastname: Zhang
authors.forename: Y
authors.initials: Y
authors.lastname: Ding
authors.forename: L-H
authors.initials: LH
authors.lastname: Chen
authors.forename: J
authors.initials: J
authors.lastname: Guan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D002681:China / Q000453:epidemiology; D003131:Combined Modality Therapy / Q000379:methods / Q000401:mortality; D000069347:Erlotinib Hydrochloride / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020266:Radiotherapy, Conformal / Q000379:methods / Q000401:mortality; D015996:Survival Rate / Q000639:trends
chemical_list: D000970:Antineoplastic Agents; D000069347:Erlotinib Hydrochloride