title: Long-term follow-up of patients with locally advanced non-small cell lung cancer receiving concurrent hypofractionated chemoradiotherapy with or without cetuximab.
abstract: OBJECTIVE
  Radiation dose escalation using hypofractionation might improve overall survival (OS). We investigated OS in a phase II multicenter study in locally advanced non-small cell lung cancer (LA-NSCLC) patients treated with hypofractionated concurrent chemoradiotherapy.
  
  
  METHODS
  A 2-armed phase II, multi-center study (NTR2230) was performed with the aim to assess the effect of cetuximab to concurrent chemoradiotherapy in LA-NSCLC patients (stage II/IIIA/B). Arm A received high dose radiotherapy (24 × 2.75 Gy) and concurrent daily low-dose cisplatin (6 mg/m(2)). Arm B received an identical treatment regimen with additional weekly cetuximab. Kaplan-Meier survival curves and 1-, 2- and 5-year OS proportions were calculated.
  
  
  RESULTS
  Between February 2009 and May 2011, 102 patients were randomly allocated in two arms. Median OS was 31.5 months (range 12.8-52.3), not significantly different between arms A and B; 33.0 (range 17.0-57.0) and 30.0 (11.0-52.0) months. 1-, 2- and 5-year OS rates were 74.5%, 59.4% and 37.3%, respectively. In multivariate analyses, worse performance score, V35 of the esophagus and the existence of comorbidities were significantly (P-value<0.05) associated with a shorter OS.
  
  
  CONCLUSIONS
  In this phase II trial, the median OS for the entire group was remarkably high; 31.5 months. Furthermore, 5-year OS was still 37.3%. Hypofractionation might contribute to improved OS in LA-NSCLC patients.
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Iris
authors.initials: I
authors.lastname: Walraven
authors.affiliation: Department of Thoracic Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Michel
authors.initials: M
authors.lastname: van den Heuvel
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Judi
authors.initials: J
authors.lastname: van Diessen
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Eva
authors.initials: E
authors.lastname: Schaake
authors.affiliation: Department of Thoracic Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Wilma
authors.initials: W
authors.lastname: Uyterlinde
authors.affiliation: Department of Pulmonary Medicine, Amphia Hospital, Breda, The Netherlands; Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Joachim
authors.initials: J
authors.lastname: Aerts
authors.affiliation: Department of Radiation Oncology, Verbeeten Institute, Tilburg, The Netherlands.
authors.forename: Frederieke
authors.initials: F
authors.lastname: Koppe
authors.affiliation: Department of Pulmonary Medicine, Haga Hospital, The Hague, The Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: Codrington
authors.affiliation: Department of Pulmonary Medicine, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Kunst
authors.affiliation: Department of Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Edith
authors.initials: E
authors.lastname: Dieleman
authors.affiliation: Department of Radiation Oncology, MC Haaglanden, The Hague, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: van de Vaart
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Marcel
authors.initials: M
authors.lastname: Verheij
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: j.belderbos@nki.nl.
authors.forename: Jose
authors.initials: J
authors.lastname: Belderbos
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000628:therapy*; D000068818:Cetuximab / Q000008:administration & dosage; D059248:Chemoradiotherapy / Q000379:methods*; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000068818:Cetuximab; D002945:Cisplatin
keywords: Concurrent chemoradiotherapy; Hypofractionation; Non-small cell lung cancer; RTOG0617