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Long-term follow-up of patients with locally advanced non-small cell lung cancer receiving concurrent hypofractionated chemoradiotherapy with or without cetuximab

2016; Elsevier BV; Volume: 118; Issue: 3 Linguagem: Inglês

10.1016/j.radonc.2016.02.011

1879-0887

Iris Walraven, Michel M. van den Heuvel, Judi van Diessen, Eva Schaake, Wilma Uyterlinde, Joachim G.J.V. Aerts, Frederieke Koppe, Henk Codrington, Peter W.A. Kunst, Edith Dieleman, Paul van de Vaart, Marcel Verheij, J. Belderbos,

Lung Cancer Research Studies

Abstract Background and purpose Radiation dose escalation using hypofractionation might improve overall survival (OS). We investigated OS in a phase II multicenter study in locally advanced non-small cell lung cancer (LA-NSCLC) patients treated with hypofractionated concurrent chemoradiotherapy. Materials and methods A 2-armed phase II, multi-center study (NTR2230) was performed with the aim to assess the effect of cetuximab to concurrent chemoradiotherapy in LA-NSCLC patients (stage II/IIIA/B). Arm A received high dose radiotherapy (24×2.75Gy) and concurrent daily low-dose cisplatin (6mg/m 2 ). Arm B received an identical treatment regimen with additional weekly cetuximab. Kaplan–Meier survival curves and 1-, 2- and 5-year OS proportions were calculated. Results Between February 2009 and May 2011, 102 patients were randomly allocated in two arms. Median OS was 31.5months (range 12.8–52.3), not significantly different between arms A and B; 33.0 (range 17.0–57.0) and 30.0 (11.0–52.0) months. 1-, 2- and 5-year OS rates were 74.5%, 59.4% and 37.3%, respectively. In multivariate analyses, worse performance score, V35 of the esophagus and the existence of comorbidities were significantly ( P -value<0.05) associated with a shorter OS. Discussion In this phase II trial, the median OS for the entire group was remarkably high; 31.5months. Furthermore, 5-year OS was still 37.3%. Hypofractionation might contribute to improved OS in LA-NSCLC patients.