Radiotherapy Alone Versus Combined Chemotherapy and Radiotherapy in Nonresectable Non-Small-Cell Lung Cancer: First Analysis of a Randomized Trial in 353 Patients

TLDR

The study evaluates whether adding chemotherapy to standard radiotherapy improves outcomes in patients with nonresectable squamous cell or large‑cell non‑small‑cell lung cancer. Patients received 65 Gy radiotherapy, with the experimental arm also receiving vindesine, cyclophosphamide, cisplatin, and lomustine; 177 patients were randomized to radiotherapy alone and 176 to combined therapy. At two years, survival was 14 % with radiotherapy alone versus 21 % with combined therapy (P = 0.08), distant metastasis was significantly lower in the combined arm (P < 0.001), and local control remained poor in both groups (17 % vs 15 %).

Abstract

We report the results observed in a large, randomized study that compared the effects of radiotherapy alone (the standard therapy) with those of a combination of radiotherapy and chemotherapy in nonresectable squamous cell and large-cell lung carcinoma. The radiation dose was 65 Gy in each group, and chemotherapy included vindesine, cyclophosphamide, cisplatin, and lomustine. In this study, 177 patients received radiotherapy alone (group A), and 176 patients received the combined treatment (group B). The 2-year survival rate was 14% in group A and 21% in group B (P = .08). The distant metastasis rate was significantly lower in group B (P less than .001). Local control was poor in both groups (17% and 15%, respectively) and remained the major problem.