Standard treatment for patients with stage III lung cancer involves a combination of radiation therapy with chemotherapy, but researchers at the University of Michigan Comprehensive Cancer Center have found that higher doses of radiation given concurrently with chemotherapy improved survival in such patients. Results were published in the April 1 issue of International Journal of Radiation Oncology Biology Physics.
Feng-Ming Kong, MD, PHD, and colleagues looked at 237 patients with inoperable stage III non-small-cell lung cancer to study the effect of radiation dose and chemotherapy. Patients were treated with radiation therapy alone (n=106), sequential chemoradiation (n=69), or concurrent chemoradiation (n=62). Radiation dose ranged from 30 to 102.9 Gy. The primary endpoint was overall survival (OS). For patients treated with RT alone, sequential chemoradiation, and concurrent chemoradiation, median survival was 7.4, 14.9, and 15.8 months, and 5-year OS was 3.3%, 7.5%, and 19.4% respectively.. The investigators reported that Karnofsky performance status, weight loss, chemotherapy (yes/no), sequence of chemoradiation (sequential vs concurrent), and BED were significant preditors of OS.
The authors concluded: “Radiation dose and use of chemotherapy are independent predictors of OS in stage III NSCLC, and concurrent chemoradiation is associated with the best survival.