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Outcomes of patients with stage III nonsmall cell lung cancer treated with chemotherapy and radiation with and without surgery

  1. Hale B. Caglar MD1,
  2. Elizabeth H. Baldini MD, MPH1,
  3. Megan Othus MS2,
  4. Michael S. Rabin MD3,
  5. Raphael Bueno MD4,
  6. David J. Sugarbaker MD4,
  7. Steven J. Mentzer MD4,
  8. Pasi A. Jänne MD, PhD3,
  9. Bruce E. Johnson MD3,
  10. Aaron M. Allen MD1,†,*

Article first published online: 23 JUN 2009

DOI: 10.1002/cncr.24492

Issue

Cancer

Cancer

Volume 115, Issue 18, pages 4156–4166, 15 September 2009

Additional Information

How to Cite

Caglar, H. B., Baldini, E. H., Othus, M., Rabin, M. S., Bueno, R., Sugarbaker, D. J., Mentzer, S. J., Jänne, P. A., Johnson, B. E. and Allen, A. M. (2009), Outcomes of patients with stage III nonsmall cell lung cancer treated with chemotherapy and radiation with and without surgery. Cancer, 115: 4156–4166. doi: 10.1002/cncr.24492

Author Information

  1. 1

    Department of Radiation Oncology Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, Massachusetts

  2. 2

    Department of Biostatistics Dana-Farber Cancer Institute, Boston, Massachusetts

  3. 3

    Department of Medical Oncology Dana-Farber Cancer Institute, Boston, Massachusetts

  4. 4

    Division of Thoracic Surgery Brigham and Women's Hospital, Boston, Massachusetts

  1. †

    Fax: (617) 632-4247

*Department of Radiation Oncology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, MA 02215

Publication History

  1. Issue published online: 4 SEP 2009
  2. Article first published online: 23 JUN 2009
  3. Manuscript Accepted: 11 FEB 2009
  4. Manuscript Revised: 3 FEB 2009
  5. Manuscript Received: 5 JUN 2008

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Keywords:

  • carcinoma;
  • nonsmall cell;
  • lung neoplasm;
  • radiation;
  • local recurrence

The objective of this retrospective study was to identify the factors associated with improved outcome after treatment for stage III nonsmall cell lung cancer. The results indicated that the patients who were able to undergo resection appeared to have improved outcome after induction chemoradiation.

Abstract

BACKGROUND:

The objective of this study was to identify the factors associated with improved outcome after treatment for stage III nonsmall cell lung cancer (NSCLC).

METHODS:

A retrospective review of stage III NSCLC patients treated at who were treated at the Dana-Farber Cancer Institute/Brigham and Women's Cancer Center was done with institutional review board approval. Patients were followed for toxicity, local and distant failure, and overall survival. Multivariate Cox logistic regression analysis was used to determine the factors associated with treatment outcome.

RESULTS:

Between August 2000 and November 2006, 144 patients received concurrent chemoradiation (CRT) for stage III NSCLC. Eighty of 144 patients were men (56%), and the median age was 61 years (range, 33-81 years). Sixty-two patients (43%) had stage IIIA NSCLC, and 82 patients (57%) had stage IIIB NSCLC. Radiotherapy (RT) was given concurrently with chemotherapy to all patients; 100 patients (69%) received CRT without surgery, and 44 patients (31%) received with neoadjuvant CRT followed by surgical resection. The median RT dose was 60 grays (Gy) (range, 46-70 Gy). The median follow-up was 15 months (range, 3-64 months), the median potential follow-up was 37 months (range, 12-84 months), and the median overall survival was 22 months (95% confidence interval, 15-28 months). The 1-year and 2-year survival rates were 68% and 47%, respectively. Among the 44 patients who underwent resection, the median survival was 61 months, and the 2-year survival rate was 73%. On multivariate analysis, stage at the time of treatment (stage IIIA vs stage IIIB) and use of surgery were the only factors associated with improved outcome (P = .01 and P = .001, respectively).

CONCLUSIONS:

In this retrospective series, those patients who were able to undergo resection appeared to have improved outcome after induction CRT. Cancer 2009. © 2009 American Cancer Society.

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