title: Optimizing treatment and analysis of prognostic factors for locally advanced nonsmall cell lung cancer in resource-limited population.
abstract: BACKGROUND
  Lung cancer most commonly presents in advanced stages in developing countries, where combined modality treatment using chemo-radiotherapy (CTRT) is the standard of care.
  
  
  METHODS
  A retrospective audit of patients of nonsmall cell lung cancer (NSCLC) treated at a single Institute from January 2008 to December 2012 was conducted. Various prognostic factors affecting disease-free survival (DFS) and overall survival (OS) were studied by univariate and multivariate analysis. All patients were meticulously followed-up clinically and telephonic contacts.
  
  
  RESULTS
  Overall 171 patients of NSCLC were treated with definitive CTRT using concurrent chemotherapy in 66% patients and sequential therapy in 28% patients. The actuarial 2 years DFS was 17.5% and 2 years OS was 61.5%. Complete response to treatment resulted in significantly better DFS and OS. Definitive CTRT was very well-tolerated in these patients with good compliance.
  
  
  CONCLUSIONS
  Definitive CTRT, sequence being individualized depending on performance status and disease stage at presentation, is a feasible and effective treatment modality for locally advanced NSCLC patients in the developing world. Response to treatment is an important prognostic factor for treatment outcomes.
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India.
authors.forename: J P
authors.initials: JP
authors.lastname: Agarwal
authors.forename: C
authors.initials: C
authors.lastname: Hotwani
authors.forename: K
authors.initials: K
authors.lastname: Prabhash
authors.forename: A
authors.initials: A
authors.lastname: Munshi
authors.forename: S
authors.initials: S
authors.lastname: Misra
authors.forename: A
authors.initials: A
authors.lastname: Mathew
authors.forename: N
authors.initials: N
authors.lastname: Kalyani
authors.forename: V
authors.initials: V
authors.lastname: Noronha
authors.forename: S G
authors.initials: SG
authors.lastname: Laskar
authors.forename: A
authors.initials: A
authors.lastname: Joshi
authors.forename: N
authors.initials: N
authors.lastname: Purandare
authors.forename: S
authors.initials: S
authors.lastname: Tandon
authors.forename: V
authors.initials: V
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D003906:Developing Countries; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D012189:Retrospective Studies