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5-year survival rates for chemoradiotherapy boost, surgery plus induction therapy in NSCLC patients comparable

Patients with non–small cell lung cancer who received induction chemotherapy followed by either surgery for resection or a chemoradiotherapy boost showed improved 5-year overall and progression free survival rates, according to research published in the Journal of Clinical Oncology.

Researchers enrolled 246 patients who had either stage IIIA (n = 75) or stage IIIB (n = 171) non–small cell lung cancer (NSCLC). All patients received a course of three cycles of cisplatin (50 mg/m²) on day 1 and day 8, paclitaxel (175 mg/m²) on day 1 and every 21 days in addition to induction chemotherapy (45 Gy; 1.5 Gy twice daily). Patients with resectable tumors (65.4%) were randomly assigned to receive either surgery (n = 81) or a chemoradiotherapy boost (n = 80) concurrent to induction chemotherapy.

“[B]oth trimodality treatment that includes surgery and bimodality treatment without surgery but with a definitive chemoradiotherapy boost lead to excellent long-term OS and PFS,” Wilfried Ernst Erich Eberhardt, MD, from the Department of Medical Oncology at the West German Cancer Centre and University Hospital Essen in Essen, Germany, and colleagues wrote. “In our patients, who included those with resectable stage IIIA(N2) or selected stage IIIB NSCLC, we observed 5-year OS rates greater than 40%, an acceptable toxicity profile, and moderate treatment-induced events when performed in high-level multimodality treatment centers.”

Specifically, Eberhardt and colleagues found 5-year OS rates of 44% for patients who underwent surgery and 40% for patients who underwent a chemoradiotherapy boost (log-rank P = .34). The PFS rates for those patients who underwent surgery was 32%, whereas the chemoradiotherapy boost group had a PFS rate of 35%, according to the abstract. The researchers noted there was a 5-year OS of 34.1% for all patients (95% CI, 27.6-40.8), with 87.8% of patients (n = 216) receiving local treatment. – by Jeff Craven

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