Radiation-Based Trimodality Therapy in Stage III NSCLC
Posted: Thursday, December 6, 2018
Full-dose neoadjuvant chemoradiotherapy followed by surgery seems to be a highly effective therapy for patients with stage III non–small cell lung cancer (NSCLC). Pranshu Mohindra, MD, MBBS, of the University of Maryland School of Medicine, and colleagues presented their clinical experience with this trimodality therapy at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer (WCLC) in Toronto (Abstract P1.01-10).
“Full-dose neoadjuvant [chemoradiotherapy] followed by surgery can achieve high [overall survival] and [freedom from recurrence] even for patients with stage III NSCLC, much higher than recent reports of bimodality therapy,” the authors concluded.
In this single-center study, 107 patients (aged 38–82 years) with various stages of NSCLC were treated with curative intent using definitive doses of neoadjuvant chemoradiotherapy. The median age of study patients was 58.5 years, and 69% had a baseline performance status of 0.
At a median follow-up of 30 months, the estimated median overall survival was 61 months, and the estimated median freedom from recurrence was 29 months. On univariate analysis, age older 60 years and no health insurance were predictive of an increased risk of death, whereas consolidation chemotherapy was associated with improved survival. Lack of health insurance was the only predictor of disease recurrence (P < .001).
Further study is warranted to evaluate the effects of high-dose radiation trimodality therapy compared with induction chemotherapy alone.