Concurrent Chemoradiotherapy And Sequential Chemoradiotherapy For Stage â…¢ Non-small Cell Lung Cancer

Objective: To Compare the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) and sequential chemoradiotherapy (SCRT) in the treatment of stage IIINSCLC. Methods:93patients with unresectable stage III NSCLC were treated with CCRT or SCRT. CCRT group (32cases)received2cycles of chemotherapy (every21-28days) with concurrent radiotherapy followed by2cycles of chemotherapywith the same drugs.SCRT group (53cases) received radiotherapy after2-4cyclesof chemotherapy (median2cycles) followed2cycles of chemotherapy. The chemotherapy using intensity modulated radiation therapy (IMRT)60-66Gy/30-33f (medianDT66Gy). Results: The response rates were75.0%and49.1%in CCRT and SCRT group, respectively (P<0.05).The overall survival time of19.5and17.5months,the median progression-free time in the two groups was16.5and12.0months, respectively (p<0.05).The1-,2-and3-year overall survival rates were84.4%,50.0%and21.9%in CCRT group and62.3%,22.6%and7.5%in SCRT group, respectively(p<0.05).CCRT group showed a significantly lower rate of distant metastasis thanSCRT group(P<0.05). But the local recurrence rate was similar between the two groups. The main side effects included radiation pneumonitis,radiation esophagitis, nausea/vomiting and anemia/leucopenia/thrombocytopenia. CCRT group had a significantly higher rate of III-IV grade nausea/vomiting and anemia/leucopenia/thrombocytopenia than SCRT group.Conclusion: Compared to SCRT, CCRT can improve the response rate, progression free survival and overall survival and decrease the rate ofdistant metastasis, but is associated with a higher toxicity.