The optimal chemotherapy timing in patients with inoperable locally advanced non small cell lung cancer.

BACKGROUND Only 20% of patients with stage III NSCLC are cured by surgery. There is a disagreement among the oncologists in terms of whether which regimen (induction chemotherapy followed chemoradiotherapy, concurrent chemoradiation or concurrent chemoradiation followed consolidation chemotherapy) is best choice in inoperable LA NSCLC. OBJECTIVE To evaluate chemotherapy timing in inoperable LA NSCLC (before, only concomitant or after curative chemotherapy). MATERIALS AND METHODS Total of 74 consecutive patient with LA NSCLC which was inoperable due to medical condition or stage from Kayseri Research and Training Hospital were analyzed retrospectively. The patients were divided into three groups according to treatment protocols: Induction chemotherapy followed chemoradiotherapy (Ind. CTàCRT), chemoradiotherapy (CRT) and chemoradiotherapy followed consolidation chemotherapy (CRTàCons. CT). RESULTS When evaluating progression free survival (PFS), PFS did not significantly differed among the groups (p=0,078). We found significant difference among groups (p = 0.047) in terms of overall survival. While CRTàCons. CT arm had highest mean and median survival times, Ind. CTàCRT arm had worst OS. CONCLUSIONS CRTàCons. CT treatment modality seems preferable regimen for treatment of inoperable LA NSCLC.