Consolidation chemotherapy may improve survival for patients with locally advanced non-small-cell lung cancer receiving concurrent chemoradiotherapy--retrospective analysis of 203 cases.

ABSTRACT

BACKGROUND: For patients with locally advanced non-small-cell lung cancer (LA-NSCLC), the role of consolidation chemotherapy (CCT) following concurrent chemoradiotherapy (CRT) is partially defined. The aim of this study was to evaluate the efficacy and toxicity of CCT. METHODS: The characteristics of LA-NSCLC patients treated with curative concurrent CRT from 2001 to 2010 were retrospectively reviewed. RESULTS: Among 203 patients, 113 (55.7 %) patients received CCT. The median number of delivered CCT was 3 and 89.4 % patients completed ≥2 cycles. The OS was significantly better for patients in the CCT group compared with that in the non-CCT group (median OS, 27 months vs. 16 months; 5-year OS, 30.4 % vs. 22.5 %; p = 0.012). The median PFS were 12 months in the CCT group and 9 months in the non-CCT group (p = 0.291). The survival advantages of CCT were significant for males (HR 0.63; 95 % CI, 0.44 - 0.90), patients with age < 60 years (HR 0.63; 95 % CI, 0.42 - 0.95), non-squamous histology (HR 0.44; 95 % CI, 0.25 - 0.76), pretreatment KPS ≥ 80 (HR 0.67; 95 % CI, 0.48 - 0.93), stage IIIb (HR 0.64; 95 % CI, 0.43 - 0.95), stable disease (HR 0.31; 95 % CI, 0.14 - 0.65) and radiotherapy dose ≥ 60 Gy (HR 0.69; 95 % CI, 0.48 - 1.00). There was no significant difference between the CCT group and the non-CCT group regarding treatment-related toxicities. CONCLUSIONS: CCT might further prolong survival compared with CRT alone for LA-NSCLC without increasing treatment-related toxicities, especially for males, patients with age < 60 years, non-squamous histology, pretreatment KPS ≥ 80, stage IIIb, stable disease and radiotherapy dose ≥ 60 Gy. Large size prospective investigations that incorporate patient characteristics and treatment response are warranted to validate our findings.