Choice of treatment method sequence in chemoradiotherapy for inoperable non-small cell stage III lung cancer: a retrospective analysis of survival

Background. Lung cancer ranks first in the structure of cancer incidence worldwide, and is the leading cause of death from cancer. One third of patients with non-small cell lung cancer (NSCLC) are initially inoperable due to locally advanced process. The question remains about the impact of the sequence of radiotherapy (RT) and chemotherapy (CT) sequential CRT on overall survival (OS). Purpose: to analyze the OS of patients with locally advanced inoperable stage III NSCLC, initially receiving RT or CT. Methods and Materials: A registry-based retrospective study of the OS of NSCLC stage III patients who received at least 2 courses of CT and external beam RT to total dose not less than 50 Gy 2 has been performed. Comparison was made between those initially receiving RT (RT±CT group) and CT (CT ± RT group) in intently sequential CRT. Cumulative OS was compared using chi-square method, median survival – with log-rank test. Associations between survival and contributing factors were studied using Cox regression. Results. The RT±CT and CT ± RT group were 35 and 104 patients. The 1-, 3-, 5-year OS and median OS were 71% (95% confidence interval (CI), 57%-87%) vs 61% (95% CI, 52%-70%); 40% (95% CI, 34%-66%) vs 19% (95% CI, 12%-27%); 28% (95% CI, 14%-43%) vs 6% (95% CI, 3%-14%); and 22.6 (95% CI, 9,5-35,6) vs 15.4 (95% CI, 12,0-18,8) months, χ 2=9.269, Р