Palliative chemotherapy followed by consolidation radiotherapy in patients with advanced and metastatic non-small cell lung cancer not suitable for radical treatment

Background: This is a retrospective study to assess the effectiveness of consolidation radiotherapy (CRT) following palliative chemotherapy in patients with metastatic or locally advanced non-small cell lung cancer (NSCLC) who are not suitable for radical treatment. Methods: This study involved retrospective analysis of a prospective database of Northampton Oncology Center from January 2005 through December 2010, 63 patients with advanced/metastatic NSCLC treated at the oncology center were enrolled. Patients were either treated with high dose (39/36 Gy /13-12 fractions, group 1) or low dose (20 Gy /5 fractions, group 2) CRT or there were those who were not offered any CRT (group 3). Results: There was no significant difference between the three groups as regard age, sex, performance status, comorbidities or chemotherapy given. However, there was a statistically significant difference as regard the stage P = 0.009 with more stage IV patients at group II and III compared to group I. The mean survival for the three groups was 27m, 14m & 15m respectively. There was a statistically significant improvement of survival in patients treated with high dose palliative CRT compared to the other two groups (P = 0.006). In multivariate analysis only the radiotherapy dose remains as the only statistical significant factor affecting the survival with hazard ratio 0.372 and confidence interval (0.147-0.726). Conclusion: Despite the limitation of our retrospective study, it is worth considering CRT approach for patients with advanced and metastatic NSCLC - not suitable for radical treatment - who have not progressed on chemotherapy