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

Lipin Liu, Nan Bi, Zhe Ji, Junling Li, Jingbo Wang, Xiaozhen Wang, Zhouguang Hui, Jima Lv, Jun Liang, Zongmei Zhou, Yan Wang, Weibo Yin, Luhua Wang

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. The characteristics of LA-NSCLC patients treated with curative concurrent CRT from 2001 to 2010 were retrospectively reviewed. 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. 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.