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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

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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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Authors and Affiliations

  1. Department of Medical Oncology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang, 110022, People’s Republic of China

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

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  1. Y. Sun
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  2. Q. Duan
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  3. X. Chen
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  4. W. Chen
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  5. X. Jin
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  6. R. Wu
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All authors have contributed significantly, and that all authors are in agreement with the content of the manuscript.

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Correspondence to R. Wu.

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The authors declare that they have no conflict of interest.

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This study has have been approved by the ethics committee of Shengjing Hospital of China Medical University. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

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Sun, Y., Duan, Q., Chen, X. et al. 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. Clin Transl Oncol 19, 1498–1506 (2017). https://doi.org/10.1007/s12094-017-1694-2

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  • DOI: https://doi.org/10.1007/s12094-017-1694-2

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