A prospective, multicenter, phase IIclinical study of three-dimensionalradiotherapy with concurrent chemotherapy for stage IV non-small-cell lung cancer-The impact of different pathological types on survival (PPRA-RTOG003)

Objective To evaluate the survival of different pathological types with concurrent chemotherapy and thoracic three-dimensional radiotherapy (CCTTRT) for stage Ⅳ non-small-cell lung cancer (NSCLC). Methods Two hundred and three patients of stage Ⅳ NSCLC were enrolled from 2008 to 2012.Of the 174 patients eligible for analysis, The patients of squamous carcinoma and non-squamous carcinoma were 51 and 123, respectively. Patients were treated by platinum-based chemotherapy, the median number of cycle was 4.The median dose of primary tumor was 63 Gy. Survival was calculated by Kaplan-Meier method and compared using the Logrank. Cox regression model were used to examine the effect of response on overall survival. Results Of 174 patients, the 1-, 2-, and 3-year overall survival (OS) rates and median survival time (MST) were 56%, 16%, 9% and 13 months, respectively. For patients under the same cycles of chemotherapy, the same dose of primary tumor, the same metastasis states, the same N staging, and when two cycles of chemotherapy and the recent curative effect are effective, no matter whether squamous carcinoma or non-squamous carcinoma, the 1-, 2-, and 3-year OS rates and MST were not statistically significant (all P>0.05). At the same of T staging (T1-T2), the 1-, 2-, and 3-year OS rates and MST for the patients of non-squamous carcinoma were better than squamous carcinoma (P=0.000). Multivariate analysis showed that different pathological types, gender, age and the cycles of chemotherapy were not independent factors for survival (all P>0.05), but those treated with DTPTV≥63 Gy can prolong survival time. Conclusions CCTTRT had no effect on different pathological types of survival. The survival of non-squamous carcinoma may be extended when the T staging was T1-T2.Clinical Trial Registry ClinicalTrials.gov, registration number: ChiCTRTNC10001026. Key words: Carcinoma, non-small cell lung/three-dimensional radiotherapy; Carcinoma, non-small cell lung/concurrent chemoradiotherapy; Pathological factors; Prognosis