Clinical outcome of concurrent chemo-radiotherapy for patients with stage IV non-small cell lung cancer

Objective: To analyze the clinical outcome of concurrent chemo-radiotherapy in stage IV non-small cell lung cancer(NSCLC). Methods: From Jan. 1997 to Dec. 2006, 214 patients with pathologically or cytologically proven stage IV NSCLC were included in this analysis. Of those patients, 98 received radiotherapy concurrently with 3-week cycle chemotherapy (group A), 18 received radiotherapy concurrently with weekly chemotherapy( group B), 44 received chemotherapy alone, 37 received radiotherapy alone and 13 received sequential chemo-radiotherapy. The primary tumor was treated by three-dimensional conformal radiotherapy(3DCRT) or conventional radiotherapy with conventional fractionation or late-course accelerated hyperfraction (LAHRT). Group A received 21-28 days cycle cisplatin-based chemotherapy (cisplatin combined with PTX, DTY, NVB or Vp-16), and group B received weekly DDP combined with PTX or toptecon for 4-6 weeks. Results: The follow-up rate was 99%. The 1- and 2-year overall survival rates of group A, group B, chemotherapy alone, radiotherapy alone and sequential chemo-radiotherapy were 41% and 11%, 16% and 0, 31% and 7%, 34% and 10%, 26% and 3%, respectively(χ2=11.18, P=0.025). The patients with concurrent 3DCRT, LAHRT and radiotherapy dose ≥70 Gy had better survival in group A than those in chemotherapy alone group. Patients who received ≥2 cycles chemotherapy with concurrent radio-therapy had longer survival time than those who had ≥2 cycles chemotherapy alone. Conclusions: Concurrent chemotherapy and 3 DCRT, LAHRT with the dose ≥70 Gy can improve the overall survival of patients with stage IV non-small cell lung cancer. (authors)