Reviewers: Li Liu, MD
Source: Journal of Clinical Oncology, 17(9): 2692, September 1999
This is a long-term follow-up of a landmark study by the West Japan Lung Cancer Group (WJLCG) directly comparing concurrent chemoradiation to sequential chemoradiation for patients with unresectable stage III non-small-cell lung cancer (NSCLC). Patients in both arms of the study received two courses of MVP (Cisplatin, Vindesine, and Mitomycin) and 56Gy of thoracic radiotherapy. The radiotherapy was delivered as a continuous course in the sequential arm of the trial but as a split-course in the concurrent arm with a 10-day break after the first 28Gy.
The Radiation Therapy Oncology Group (RTOG) is expected to report a 3-arm study comparing concurrent conventionally fractionated chemoradiation Vs concurrent hyperfractionated chemoradiation Vs sequential chemoradiation in the year 2000. In this trial, the thoracic radiotherapy dose was 63Gy in a continuous course and chemotherapy was cisplatin/vinblastine. This regimen is considered more conventional by US standards.
From the conclusions of these two trials, hopefully we will be able to reach a consensus regarding optimal treatment for selected patients with unresectable stage III NSCLC.