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Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 12/2017

01-12-2017 | Research Article

Comparative efficacy and toxicity of induction chemotherapy with concurrent stereotactic body radiotherapy and stereotactic body radiotherapy with subsequent chemotherapy in patients with clinical stage T1-3N0M0 non-small cell lung carcinoma

Authors: Y. Sun, Q. Duan, X. Chen, W. Chen, X. Jin, R. Wu

Published in: Clinical and Translational Oncology | Issue 12/2017

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Abstract

Purpose

We compared the clinical efficacy and toxicity of stereotactic body radiotherapy with induction chemotherapy and concurrent radiochemotherapy vs stereotactic body radiotherapy with subsequent chemotherapy in patients with clinical stage T1-3N0M0 non-small cell lung carcinoma.

Methods

We retrospectively analyzed 38 patients with c-stage T1-3N0M0 non-small cell lung carcinoma who received stereotactic body radiotherapy. All patients received six cycles of chemotherapy. Fifteen of the patients were treated with three cycles of induction chemotherapy, one cycle of concurrent radiochemotherapy, and then two cycles of consolidation chemotherapy, while 23 patients received Sequential Radiotherapy/Chemotherapy.

Results

Patients in the induction chemotherapy group experienced a longer duration of esophagitis (median 2 vs 0, range 0–6 vs 0–3.6 weeks, p = 0.04). We divided the patients into two groups based on their median pre-treatment tumor volume (cm3): >32.11 and ≤32.11. The tumor response rate in patients with larger tumor volume was substantially higher in the induction chemotherapy group than in the Sequential Radiotherapy/Chemotherapy group (66.67 vs 40%). Among patients with pre-treatment tumor volume (cm3) >32.11, the median local progression-free survival (LPFS) in the induction chemotherapy group and Sequential Radiotherapy/Chemotherapy group was 18 months (range 7–72 months) and 11 months (range 6–53 months), respectively. There was a statistically significant difference between the two groups (p = 0.006).

Conclusions

Simultaneous SBRT and chemotherapy can result in a longer duration of esophagitis. However, for patients with large tumor volume, ICT combined with concurrent radiochemotherapy may result in better local tumor response as well as longer LPFS and progression-free survival. To better elucidate the best treatment, further clinical trials are needed.
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Metadata
Title
Comparative efficacy and toxicity of induction chemotherapy with concurrent stereotactic body radiotherapy and stereotactic body radiotherapy with subsequent chemotherapy in patients with clinical stage T1-3N0M0 non-small cell lung carcinoma
Authors
Y. Sun
Q. Duan
X. Chen
W. Chen
X. Jin
R. Wu
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 12/2017
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-017-1694-2

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