Concurrent chemotherapy delivered with radiation decreased locoregional progression and improved survival in locally advanced non–small cell lung cancer compared with sequential chemotherapy delivered before and/or after radiation. The results of this study were published early online in the Journal of Clinical Oncology.
Lung cancer is a major cause of death worldwide, with over one million deaths per year. Non–small cell lung cancer (NSCLC) is the most common type of lung cancer and refers to the type of cell within the lung where the cancer originated. Locally advanced NSCLC refers to cancer that has not spread to distant sites in the body. Treatment for NSCLC often includes surgery, radiation therapy, chemotherapy, and/or biologic therapy.
Previous research has indicated that adding sequential or concurrent chemotherapy to radiation improves survival in locally advanced NSCLC. In a recent analysis, the NSCLC Collaborative Group examined data from six studies in order to compare concurrent versus sequential radiation and chemotherapy.
The data included 1,205 patients from six studies with a median follow-up of six years. Concurrent radiochemotherapy provided a significant benefit to overall survival compared with sequential chemotherapy and radiation. In addition, the concurrent therapy was shown to decrease locoregional progression but did not appear to provide any benefit for distant progression compared with sequential therapy.
The concurrent therapy significantly increased acute esophageal toxicity (from 4% to 18%); however, there was no significant difference between the two therapies on acute pulmonary toxicity.
The researchers concluded that concurrent radiation and chemotherapy improved overall survival and locoregional progression compared with sequential therapy; however, the improvement came at the cost of higher esophageal toxicity.
 Auperin A, Le Pechoux C, Rolland E, et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. Journal of Clinical Oncology [early online publication]. March 29, 2010.?
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