1200P - Concomitant chemoradiation gives significant survival and HRQOL benefits in patients with locally advanced stage III non small cell lung cancer (NSC...

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Locally Advanced
Surgery and/or Radiotherapy of Cancer
Presenter Hans Strøm
Authors H.H. Strøm1, S. Sundstrøm2, N. Helbekkmo3, R. Bremnes3, U. Aasebø4
  • 1Medical Department, Helgelands Hospital, 8800 - Sandnessjøen/NO
  • 2Oncology, St.Olavs Hospital, N-7006 - Trondheim/NO
  • 3Oncology, University Hospital of Northern Norway, 8093 - Tromsø/NO
  • 4Medical, University Hospital of Northern Norway, 8093 - Tromsø/NO

Abstract

Background

In patients with locally advanced, inoperable NSCLC and negative prognostic factors, treatment will be of palliative intent. Platinum-based chemotherapy and thoracic radiation are both well documented, but the role of chemoradiation has not been established. Objective: Will concomitant radio- and chemotherapy (chemoradiation), when compared to chemotherapy alone, be superior with respect to survival and health-related quality of life (HRQOL) in patients with incurable NSCLC stage III (negative prognostic factors)?

Methods

Stage III NSCLC patients, not eligible for curative radiotherapy due to tumor size ≥ 8 cm or performance status 2 or weight loss ≥ 10 % during the last 6 months, were randomized to receive either chemoradiation or chemotherapy alone. Chemotherapy consisted of 4 cycles of carboplatin iv day 1 and vinorelbine po day 1 and 8, with 3-week intervals. Patients in the chemoradiation arm also received radiotherapy with fractionation 42 Gy/2.8 Gy, starting at the 2nd chemo course. The primary endpoint was overall survival. Secondary endpoints were HRQOL and toxicity.

Results

191 patients from 25 Norwegian hospitals were randomized from Nov 2006 until Nov 2011, when enrollment was terminated due to slow accrual. Median age was 67 years and 20% had PS 2. In the chemotherapy versus the concomitant arm, the median overall survival was 9.7 and 13.3 months, respectively (p < 0.01).1-year survival 31.9 % and 51.1%, respectively (p < 0.01). Following a minor decline in global QOL during treatment, patients in the chemoradiation arm improved over the subsequent months, while those in the chemotherapy only arm reported gradual deterioration. In the chemoradiation arm, there were more hospital admissions related to side effects (p < 0.01) as 31.5 % of these patients reported esophagitis grade 3, but none grade 4.

Conclusions

Of the 2 investigated treatment regimens; chemoradiation was superior to chemotherapy alone with respect to both survival and global HRQOL, at the expense of more hospital admissions due to toxicity.

Disclosure

All authors have declared no conflicts of interest.