Improved survival with dose-escalated radiotherapy in stage III non-small-cell lung cancer: analysis of the National Cancer Database

摘要

This large retrospective analysis of the National Cancer Database (> 33 000 patients) assessed the role of dose escalation in inoperable stage III non-small-cell lung cancer (NSCLC). Dose escalation resulted in improved overall survival in comparison with current standard 60 Gy, with no significant benefit to dose > 70 Gy in comparison with 66-70 Gy. These data highlight the importance of further investigation into dose escalation in the setting of inoperable stage III NSCLC.Concurrent chemoradiation is the standard of care in non-operable stage III non-small-cell lung cancer (NSCLC). Data have suggested a benefit of dose escalation; however, results from the randomized dose-escalation trial RTOG 0617 revealed a lower survival rate with high-dose radiation. To evaluate the impact of dose escalation on overall survival (OS) in stage III NSCLC treated with chemoradiotherapy outside the controlled setting of a randomized trial, we carried out an observational, population-based investigation of the National Cancer Database (NCDB).