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

Abstract

BackgroundFor 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.MethodsThe characteristics of LA-NSCLC patients treated with curative concurrent CRT from 2001 to 2010 were retrospectively reviewed.ResultsAmong 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.ConclusionsCCT 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-015-1710-2) contains supplementary material, which is available to authorized users.

Effect of consolidation chemotherapy following definitive chemoradiotherapy in patients with esophageal squamous cell cancer

“…Consolidation chemotherapy (CCT) after initial treatment is intended to improve cancer patient outcomes and has shown efficacy in some cancers, such as cervical 10 and non-small-cell lung cancer 11 . However, reports on CCT for patients with esophageal cancer after dCRT are rare.…”

Oral vinorelbine plus cisplatin with concomitant radiotherapy as induction therapy for stage III non‐small cell lung cancer: Results of a single‐arm prospective cohort study

“…The role of consolidation CT after CCRT for locally advanced NSCLC still remains unclear. Consolidation CT may improve OS of patients with locally advanced NSCLC receiving CCRT, but not the response rate and PFS . Moreover, analysis failed to show evidence that CCRT provided any significant survival benefit for locally advanced NSCLC .…”

The Effect of Consolidation Chemotherapy for LA-NSCLC Patients Receiving Concurrent Chemoradiotherapy

“…In a retrospective analysis of 203 LA-NSCLC patients, Liu et al found that CCT might prolong survival compared with CRT alone. The benefit was mostly observed in males, patients < 60 years of age, with non-squamous histology, pre-treatment KPS ≥ 80, Stage IIIB, stable disease, and radiotherapy dose ≥ 60 Gy [9]. In a similar Turkish study, Stage IIIB NSCLC patients treated with CRT followed by CCT had a superior outcome in terms of PFS and OS when compared to induction chemotherapy followed by CRT or exclusive chemoradiotherapy groups [15].…”

“…The Southwest Oncology Group had treated patients with concurrent CRT followed by a consolidation docetaxel monotherapy and achieved a promising median survival of 26 months [8]. A retrospective analysis of 203 cases showed that CCT might prolong survival compared with exclusive CRT for LA-NSCLC, especially for males, patients < 60 years of age, with non-squamous histology, pre-treatment KPS ≥ 80, Stage IIIB, stable disease, and radiotherapy dose ≥ 60 Gy [9]. In contrast, a recent pooled analysis of 45 studies on CCT revealed no survival benefit for the LA-NSCLC patients [2].…”