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. 2020 Apr 6;20(1):278.
doi: 10.1186/s12885-020-06780-x.

Efficacy and safety of concurrent chemoradiotherapy in ECOG 2 patients with locally advanced non-small-cell lung cancer: a subgroup analysis of a randomized phase III trial

Nan Bi  1 , Lipin Liu  1 , Jun Liang  1 , Shixiu Wu  2 , Ming Chen  3 , Changxing Lv  4 , Lujun Zhao  5 , Anhui Shi  6 , Wei Jiang  7 , Yaping Xu  8 , Zongmei Zhou  1 , Jingbo Wang  1 , Wenqing Wang  1 , Dongfu Chen  1 , Zhouguang Hui  1 , Jima Lv  1 , Hongxing Zhang  1 , Qinfu Feng  1 , Zefen Xiao  1 , Xin Wang  1 , Tao Zhang  1 , Weibo Yin  1 , Junling Li  9 , Jie He  10 , Luhua Wang  11   12
Affiliations

Efficacy and safety of concurrent chemoradiotherapy in ECOG 2 patients with locally advanced non-small-cell lung cancer: a subgroup analysis of a randomized phase III trial

Nan Bi et al. BMC Cancer. .

Abstract

Background: There is no consensus on the therapeutic approach to ECOG 2 patients with locally advanced non-small-cell lung cancer (LA-NSCLC), despite the sizable percentage of these patients in clinical practice. This study focused on the efficacy, toxicity and the optimal chemotherapy regimen of CCRT in ECOG 2 patients in a phase III trial.

Methods: Patients capable of all self-care with bed rest for less than 50% of daytime were classified as ECOG 2 subgroup. A subgroup analysis was performed for ECOG 2 patients recruited in the phase III trial receiving concurrent EP (etoposide + cisplatin)/PC (paclitaxel + carboplatin) chemotherapy with intensity-modulated radiation therapy (IMRT) or three-dimensional conformal external beam radiation therapy (3D-CRT).

Results: A total of 71 ECOG 2 patients were enrolled into the study. Forty-six (64.8%) patients were treated with IMRT technique. The median overall survival (OS) and progression free survival (PFS) for ECOG 2 patients were 16.4 months and 9 months, respectively. No difference was observed in treatment compliance and toxicities between ECOG 2 patients and ECOG 0-1 patients. Within the ECOG 2 group (31 in the EP arm and 40 in the PC arm), median OS and 3-year OS were 15.7 months and 37.5% for the EP arm, and 16.8 months and 7.5% for the PC arm, respectively (p = 0.243). The incidence of grade ≥ 3 radiation pneumonitis was higher in the PC arm (17.5% vs. 0.0%, p = 0.014) with 5 radiation pneumonitis related deaths, while the incidence of grade 3 esophagitis was numerically higher in the EP arm (25.8% vs. 10.0%, p = 0.078).

Conclusions: CCRT provided ECOG 2 patients promising outcome with acceptable toxicities. EP might be superior to PC in terms of safety profile in the setting of CCRT for ECOG 2 patients. Prospective randomized studies based on IMRT technique are warranted to validate our findings.

Trial registration: ClinicalTrials.gov registration number: NCT01494558. (Registered 19 December 2011).

Keywords: Chemoradiotherapy; ECOG 2; Efficacy; Locally advanced; Non-small-cell lung cancer; Toxicity.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
a-b, Kaplan-Meier curves by arm and ECOG status for overall survival (a) and progression-free survival (b). c, Cumulative incidence function of cancer death from competing risk survival analysis by arm and ECOG status. P values were from log-rank tests for a and b, and from Fine and Gray’s method for c. PC = paclitaxel/carboplatin; EP = etoposide/cisplatin; ECOG = Eastern Cooperative Oncology Group performance score
Fig. 2
Fig. 2
Forest plot of HRs for overall survival by prognostic factors. PC = paclitaxel/carboplatin; EP = etoposide/cisplatin; HR = hazard ratio; CI = confidence interval
See this image and copyright information in PMC

References

    1. Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc. 2008;83(5):584–594. doi: 10.1016/S0025-6196(11)60735-0. - DOI - PMC - PubMed
    1. Yang P, Allen MS, Aubry MC, Wampfler JA, Marks RS, Edell ES, Thibodeau S, Adjei AA, Jett J, Deschamps C. Clinical features of 5,628 primary lung cancer patients: experience at Mayo Clinic from 1997 to 2003. Chest. 2005;128(1):452–462. doi: 10.1378/chest.128.1.452. - DOI - PubMed
    1. Chansky K, Sculier JP, Crowley JJ, Giroux D, Van Meerbeeck J, Goldstraw P. The International Association for the Study of Lung Cancer staging project: prognostic factors and pathologic TNM stage in surgically managed non-small cell lung cancer. J Thoracic Oncology. 2009;4(7):792–801. doi: 10.1097/JTO.0b013e3181a7716e. - DOI - PubMed
    1. Verger E, Salamero M, Conill C. Can Karnofsky performance status be transformed to the Eastern Cooperative Oncology Group scoring scale and vice versa? Eur J Cancer. 1992;28a(8–9):1328–1330. doi: 10.1016/0959-8049(92)90510-9. - DOI - PubMed
    1. Auperin A, Le Pechoux C, Rolland E, Curran WJ, Furuse K, Fournel P, Belderbos J, Clamon G, Ulutin HC, Paulus R, et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol. 2010;28(13):2181–2190. doi: 10.1200/JCO.2009.26.2543. - DOI - PubMed

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