When compared to treating inoperable non-small-cell lung cancer (NSCLC) with chemotherapy alone, Chemoradiation was superior to chemotherapy alone with respect to survival and health-related quality of life (HRQoL) at the expense of more hospital admissions due to toxicity, according to investigators writing in the British Journal of Cancer.
For the phase III study, researchers enrolled 191 NSCLC patients who were ineligible for curative radiotherapy, all of whom had at least one negative prognostic factor, such as tumor size of 8 cm or more, performance status (PS) of 2 or more, or weight loss of more than 10% in the past 6 months.
Participants either received chemotherapy (4 cycles of carboplatin on day 1 and oral vinorelbin on days 1 and 8, every 21 days) alone or with radiotherapy (42 Gy per 15 fractions) starting on the second cycle of chemotherapy.
Researchers found that not only was median overall survival (12.6 months versus 9.7 months for chemotherapy-only patients), but 1-year survival (53.2% vs. 34.0%) significantly longer with chemoradiation. HRQoL declined at first in the chemoradiation group, however, the decline was “clinically insignificant.”
“Despite a transient decrease in global HRQOL due to side effects during the radiation period, the HRQOL decline during this period was limited and clinically insignificant. After the first three months though, a reasonable global HRQOL was maintained in the chemoradiation arm, whereas it declined significantly in the chemotherapy-alone arm. Thus, chemoradiation offers a longer lasting palliation relevant to HRQOL in contrast to chemotherapy alone,” the authors wrote.
Investigators noted that future trials are required to establish the best concurrent chemoradiotherapy regimen and to provide further information regarding the optimal treatment approach.