Sequential Versus Concurrent Chemo-radiotherapy in Inoperable Stage III Non-small Cell Lung Cancer

• Published in: Anticancer research Vol. 26; no. 1B; pp. 495 - 505
• Main Authors: EL SHAROUNI, S. Y, KAL, H. B, BATTERMANN, J. J, SCHRAMEL, F. M. N. H
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01.01.2006
• Subjects: Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - radiotherapy; Combined Modality Therapy; Dose Fractionation; Drug Administration Schedule; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Lung Neoplasms - radiotherapy; Medical sciences; Meta-Analysis as Topic; Neoplasm Staging; Pneumology; Survival Rate; Tumors; Tumors of the respiratory system and mediastinum; sequential chemo-radiotherapy; Lung disease; Respiratory disease; Lung cancer; Concurrent; Malignant tumor; non-small cell lung carcinoma; Radiotherapy; concurrent chemo-radiotherapy; Clinical stage; Cancerology; Treatment; Sequential; review; Bronchus disease; Inoperable non-small cell lung cancer; Comparative study; Bibliographic review
• ISSN: 0250-7005; 1791-7530

Aim: To define the best sequence of radiotherapy and chemotherapy for inoperable stage III non-small cell lung (NSCL) tumours. Materials and Methods: A systematic review was performed on the clinical results of radiotherapy, combined or not with chemotherapy, for inoperable NSCL cancer stage III. The mean median survival time (MST) and mean overall survival (OS) percentages were derived for radiotherapy only, for sequential and for concurrent chemo-radiotherapy. Results: The mean median survival duration ± standard deviation for radiotherapy only was 10.4±1.8 months. For sequential chemo- and radiotherapy it was increased to 13.0±1.2 months. When radiotherapy in the sequential regimen was accompanied by chemotherapy, the mean median duration was 15.8±2.6 months. For concurrent radio-chemotherapy it was further increased to 16.4±2.7 months. The mean 2- and 3-year overall survivals for radiotherapy alone, sequential and concurrent radio-chemotherapy were 17.1±4.6 and 10, 23.8±6.3 and 18.5±7.0, and 32.5±8.7 and 25.7±6.3%, respectively. Conclusion: Concurrent chemo-radiotherapy demonstrated increased efficacy over sequential chemotherapy and radiotherapy and should be the treatment of choice. Further improvements may be obtained by optimising the conditions for concurrent chemo-radiotherapy.