Email updates

Keep up to date with the latest news and content from BMC Cancer and BioMed Central.

Open Access Research article

Radiation dose and survival of patients with stage IV non-small cell lung cancer undergoing concurrent chemotherapy and thoracic three-dimensional radiotherapy: reanalysis of the findings of a single-center prospective study

Wei-Wei Ouyang123, Sheng-Fa Su123, Yin-Xiang Hu123, Bing Lu123*, Zhu Ma123, Qing-Song Li123, Hui-Qin Li123 and Yi-Chao Geng123

Author Affiliations

1 Department of Thoracic Oncology, Affiliated Hospital of Guiyang Medical College, Guizhou, Guiyang, China

2 Guizhou Cancer Hospital, 1 Beijing Road West, Guizhou, Guiyang, China

3 Teaching and Research Section of Oncology, Guiyang Medical College, Guizhou, Guiyang, China

For all author emails, please log on.

BMC Cancer 2014, 14:491  doi:10.1186/1471-2407-14-491

Published: 8 July 2014

Abstract

Background

The objective of this study was to evaluate the radiation dose and response in terms of local-regional progression-free survival (LRPFS) and overall survival (OS) of patients with stage IV non-small cell lung cancer (NSCLC) undergoing concurrent chemotherapy and thoracic three-dimensional radiotherapy.

Methods

In all, we enrolled 201 patients with stage IV NSCLC in this study and analyzed OS in 159 patients and LRPFS in 120.

Results

The 1-, 2-, 3-, and 5-year OS rates were 46.2%, 19.5%, 11.7%, and 5.8%, respectively, the median survival time being 12 months. The median survival times in differential treatment response of primary tumors were 19 of complete response, 13 of partial response, 8 of stable disease, and 6 months of progressive disease, respectively (P = 0.000). The 1-, 2-, 3-, and 5-year LRPFS rates of patients undergoing four to five cycles with doses ≥63 Gy and <63 Gy were 77.4% and 32.6%, 36.2% and 21.7%, 27.2% and 0, and 15.9% and 0, respectively (P = 0.002). According to multivariate analyses, four to five cycles of chemotherapy, gross tumor volume <175.00 cm3 and post-treatment Karnofsky Performance Status score stable or increased by at least 10 units were independent prognostic factors for better OS (P = 0.035, P = 0.008, and P = 0.000, respectively). Radiation dose to the primary tumor ≥63 Gy resulted in better OS (P = 0.057) and LRPFS (P = 0.051), both findings being of borderline significance.

Conclusions

Treatment of IV NSCLC with joint administration of four to five cycles of chemotherapy and three-dimensional radiotherapy may prolong survival, particularly in patients receiving ≥63 Gy radiotherapy, with gross tumor volume <175.00 cm3 and post-treatment Karnofsky Performance Status score not lower than pretreatment values.

Keywords:
Non-small cell lung cancer; Stage IV; Concurrent chemoradiotherapy; Thoracic three-dimensional radiotherapy; Dose; Response