PURPOSE: To study the effects of radiation dose, chemotherapy, and their interaction in patients with unresectable or medically inoperable Stage III non-small-cell lung cancer (NSCLC). METHODS AND MATERIALS: A total of 237 consecutive Stage III NSCLC patients were evaluated. Median follow-up was 69.0 months. Patients were treated with radiation therapy (RT) alone (n = 106), sequential chemoradiation (n = 69), or concurrent chemoradiation (n = 62). The primary endpoint was overall survival (OS). Radiation dose ranged from 30 to 102.9 Gy (median 60 Gy), corresponding to a bioequivalent dose (BED) of 39 to 124.5 Gy (median 72 Gy). RESULTS: The median OS of the entire cohort was 12.6 months, and 2- and 5-year survival rates were 22.4% and 10.0%, respectively. Multivariable Cox regression model demonstrated that Karnofsky performance status (p = 0.020), weight loss < 5% (p = 0.017), chemotherapy (yes vs. no), sequence of chemoradiation (sequential vs. concurrent; p < 0.001), and BED (p < 0.001) were significant predictors of 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 (p < 0.001). The effect of higher radiation doses on survival was independent of whether chemotherapy was given. CONCLUSION: Radiation dose and use of chemotherapy are independent predictors of OS in Stage III NSCLC, and concurrent chemoradiation is associated with the best survival. There is no interaction between RT dose and chemotherapy.
PURPOSE: To study the effects of radiation dose, chemotherapy, and their interaction in patients with unresectable or medically inoperable Stage III non-small-cell lung cancer (NSCLC). METHODS AND MATERIALS: A total of 237 consecutive Stage III NSCLC patients were evaluated. Median follow-up was 69.0 months. Patients were treated with radiation therapy (RT) alone (n = 106), sequential chemoradiation (n = 69), or concurrent chemoradiation (n = 62). The primary endpoint was overall survival (OS). Radiation dose ranged from 30 to 102.9 Gy (median 60 Gy), corresponding to a bioequivalent dose (BED) of 39 to 124.5 Gy (median 72 Gy). RESULTS: The median OS of the entire cohort was 12.6 months, and 2- and 5-year survival rates were 22.4% and 10.0%, respectively. Multivariable Cox regression model demonstrated that Karnofsky performance status (p = 0.020), weight loss < 5% (p = 0.017), chemotherapy (yes vs. no), sequence of chemoradiation (sequential vs. concurrent; p < 0.001), and BED (p < 0.001) were significant predictors of 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 (p < 0.001). The effect of higher radiation doses on survival was independent of whether chemotherapy was given. CONCLUSION: Radiation dose and use of chemotherapy are independent predictors of OS in Stage III NSCLC, and concurrent chemoradiation is associated with the best survival. There is no interaction between RT dose and chemotherapy.
Authors: M A Socinski; J G Rosenman; J Halle; M J Schell; Y Lin; S Russo; M P Rivera; J Clark; S Limentani; R Fraser; W Mitchell; F C Detterbeck Journal: Cancer Date: 2001-09-01 Impact factor: 6.860
Authors: K Furuse; M Fukuoka; M Kawahara; H Nishikawa; Y Takada; S Kudoh; N Katagami; Y Ariyoshi Journal: J Clin Oncol Date: 1999-09 Impact factor: 44.544
Authors: Jeffrey D Bradley; Nantaken Ieumwananonthachai; James A Purdy; Todd H Wasserman; Mary Ann Lockett; Mary V Graham; Carlos A Perez Journal: Int J Radiat Oncol Biol Phys Date: 2002-01-01 Impact factor: 7.038
Authors: José S A Belderbos; Katrien De Jaeger; Wilma D Heemsbergen; Yvette Seppenwoolde; Paul Baas; Liesbeth J Boersma; Joos V Lebesque Journal: Radiother Oncol Date: 2003-02 Impact factor: 6.280
Authors: Julian G Rosenman; Jan S Halle; Mark A Socinski; Katharin Deschesne; Dominic T Moore; Harold Johnson; Robert Fraser; David E Morris Journal: Int J Radiat Oncol Biol Phys Date: 2002-10-01 Impact factor: 7.038
Authors: Ramesh Rengan; Kenneth E Rosenzweig; Ennapadam Venkatraman; Lawrence A Koutcher; Jana L Fox; Reena Nayak; Howard Amols; Ellen Yorke; Andrew Jackson; C Clifton Ling; Steven A Leibel Journal: Int J Radiat Oncol Biol Phys Date: 2004-11-01 Impact factor: 7.038
Authors: Lujun Zhao; Brady T West; James A Hayman; Susan Lyons; Kemp Cease; Feng-Ming Kong Journal: Int J Radiat Oncol Biol Phys Date: 2007-03-23 Impact factor: 7.038
Authors: Tawee Tanvetyanon; Michelle Corman; Ji-Hyun Lee; William J Fulp; Fred Schreiber; Richard H Brown; Richard M Levine; Thomas H Cartwright; Guillermo Abesada-Terk; George P Kim; Carlos Alemany; Douglas Faig; Philip V Sharp; Merry-Jennifer Markham; Gerold Bepler; Erin Siegel; David Shibata; Mokenge Malafa; Paul B Jacobsen Journal: J Oncol Pract Date: 2011-11 Impact factor: 3.840
Authors: Tejan P Diwanji; Pranshu Mohindra; Melissa Vyfhuis; James W Snider; Chaitanya Kalavagunta; Sina Mossahebi; Jen Yu; Steven Feigenberg; Shahed N Badiyan Journal: Transl Lung Cancer Res Date: 2017-04
Authors: Li Wang; Candace R Correa; James A Hayman; Lujun Zhao; Kemp Cease; Dean Brenner; Doug Arenberg; Jeffery Curtis; Gregory P Kalemkerian; Feng-Ming Kong Journal: Int J Radiat Oncol Biol Phys Date: 2009-02-21 Impact factor: 7.038
Authors: Klaudia U Hunter; Feng-Ming Spring Kong; Indrin J Chetty; Paul Cronin; Daniel Tatro; Charles Marn; James A Hayman; Randall K Ten Haken Journal: J Radiat Oncol Date: 2012-09