ASTRO: Standard-Dose CRT Beats Higher Dose in Stage III NSCLC
WEDNESDAY, Sept. 27, 2017 -- For patients with stage III non-small-cell lung cancer, standard-dose (SD) chemoradiation therapy is better than high-dose (HD) treatment, with higher five-year overall survival rates, according to a study presented at the annual meeting of the American Society for Radiation Oncology (ASTRO), held from Sept. 24 to 27 in San Diego.
Jeffrey D. Bradley, M.D., from the Washington University School of Medicine in St. Louis, and colleagues conducted a phase III randomized trial to compare SD (60 Gy) with high-dose (HD; 74 Gy) chemoradiation therapy and to assess the efficacy of cetuximab for 496 patients with stage III non-small-cell lung cancer. Patients were followed for a median of 5.1 years for the primary end point of overall survival.
The researchers found that for the SD and HD arms, the median overall survival was 28.7 versus 20.3 months, respectively. The five-year overall survival rates were 32.1 versus 23 percent (P = 0.004), and progression-free survival rates were 18.3 versus 13 percent (P = 0.055), favoring the SD arm. In multivariable analysis, factors affecting overall survival included radiation dose favoring SD, tumor location, institution accrual volume, esophagitis/dysphagia, planning target volume, and V5 heart dose/volume. Cetuximab use conferred no benefit.
"This report also confirms that using a higher radiation dose is not beneficial and can lead to detrimental outcomes including lower survival rates and increased side effects," Bradley said in a statement.
Several authors disclosed financial ties to medical technology and pharmaceutical companies. Eli Lilly provided funding for the study.
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Posted: September 2017