From: A critical review of recent developments in radiotherapy for non-small cell lung cancer
Trial | Inclusion | Staging PET or PET/CT | Study question | RTa | Chemotherapy | N (randomized) | Answer | Treatment related mortality | 5-year OS |
---|---|---|---|---|---|---|---|---|---|
EORTC 08941 [125] | Unresectable IIIA (N2) | Not mandatory | CT-S vs CT-RT | 60–62.5 Gy to primary and involved mediastinum; 40–46 Gy to uninvolved mediastinum | Platinum-based with at least one other agent | 332 | No significant difference | 4 % within 30 days of surgery 1 patient died of RP, timing NR | 16 % 14 % |
INT 0139b [126] | Potentially resectable IIIA (N2) | Not mandatory | CRT-S vs CRT | 45Â Gy in CRT-S arm 61Â Gy in CRT arm | Cisplatin-etoposide | 429 (396 eligible) | No significant difference | 8Â % 2Â % (No deaths during induction) | 27Â % 20Â % |
ESPATUEc [127] | Resectable IIIA (N2) and selected IIIB | 97 % | CT-CRT-S vs CT-CRT-CRTboost | Both arms: induction 45 Gy delivered as 1.5 Gy BID In definitive CRT arm: risk-adapted CRTboost to 65–71 Gy | Induction: cisplatin-paclitaxel Concurrent: cisplatin-vinorelbine | 161 | No significant difference, but closed early and was under- powered with respect to the primary end-point of OS | 6 % in surgical arm 3 % in definitive CRT arm (2 additional patients died during induction) | 44 % 40 % |
SAKK 16/00 [128] | Resectable IIIA (N2) | Required (rate NR) | CT-RT-S vs CT-S | 44Â Gy (in 22 fractions over 3Â weeks) | Cisplatin-docetaxel | 232 | No difference | 0Â % within 30Â days of surgery 3Â % within 30Â days of surgery | 40Â % 34Â % |