Reaching the pinnacle of stage III NSCLC treatment

Background

Standard treatment for stage III non-small cell lung cancer (NSCLC) is concurrent radical chemo-radiation (CRCR). However, many stage III patients are not candidates for CRCR and there is no level I based consensus on the optimal chemotherapy, duration of systemic treatment or dose of radiation. We examined the uptake and outcome of CRCR at the Tom Baker Cancer Centre (TBCC) over a 12 year period.

Methods

The Glans-Look Lung Cancer database was used to identify all stage III NSCLC patients seen at the TBCC January 1^st 1999 to June 30^th 2012. Basic demographics, treatment, progression date, and overall survival were reviewed. Median survival (MS) was compared between different treatment modalities using Kaplan-Meier survival analysis. Radical radiation (RR) was defined as ≥60G.

Results

1232 stage III NSCLC patients were identified, median age 69, 55% male, 90% current or former smokers, and MS of 14.7 months (m) (95% CI, 13.7, 15.8). 74% received radiation therapy (MS 16.6 m) of whom 73% received palliative radiation with MS of 15.3 m (95% CI, 14.2, 16.4). The 27% who received RR had a MS of 24.1 m (95% CI, 21.0, 27.3; p 

Conclusions

Although the highest MS in stage III NSCLC patients is associated with CRCR, almost 80% did not receive guideline recommended treatment for their disease. In this retrospective study, platin/Paclitaxel offered highest MS, however the uptake of CRCR has plateaued. New, more palatable treatment for Stage III NSCLC is required.

Clinical trial identification

Not applicable

Legal entity responsible for the study

University of Calgary

Funding

Private donations

Disclosure

All authors have declared no conflicts of interest.