PT  - JOURNAL ARTICLE
AU  - Amanda Tufman
AU  - Tibor Schuster
AU  - Astrid Borgmeier
AU  - Michael Schmidt
AU  - Kurt Ulm
AU  - Michael Flentje
AU  - Rudolf Maria Huber
TI  - Site of first progression (PR) differs between stage III NSCLC patients treated with simultaneous radiochemotherapy (RTCT) and those treated with radiotherapy (RT) alone following induction chemotherapy (CT)
DP  - 2014 Sep 01
TA  - European Respiratory Journal
PG  - 1926
VI  - 44
IP  - Suppl 58
4099  - http://erj.ersjournals.com/content/44/Suppl_58/1926.short
4100  - http://erj.ersjournals.com/content/44/Suppl_58/1926.full
SO  - Eur Respir J2014 Sep 01; 44
AB  - Background:RTCT can be curative in stage III NSCLC; however, most tumours progress despite intensive treatment. Efforts to understand and predict PR after RTCT are ongoing.The CTRT 99/97 Bronchial Carcinoma Therapy (BROCAT) study (Huber et al., JCO 2006) showed that, after induction CT with paclitaxel and carboplatin, RTCT with paclitaxel leads to longer PFS than RT alone. Here we present site of first PR data for patients in the BROCAT trial.Methods:We analysed site of first PR in the BROCAT study, comparing local, central nervous system (CNS), and systemic PR.Results:The BROCAT trial enrolled 303 patients, and, after induction CT, randomized 214 to RT (n=113) or RTCT (n=101). There was longer progression free survival in the RTCT arm, and a trend to longer overall survival.Site of first PR was available for 102 of 165 patients with progression and differed significantly between the treatment arms (p < 0.047). CNS and distant metastases were more frequent after RT (CNS 21%, distant 36%) compared to RTCT (CNS 7%, distant 24%). Local and thoracic PR was more frequent after RTCT (55% vs. 34%).There was no significant association between histology and PR site (p = 0.328), but there was a trend to more CNS-PR in patients with large cell tumours compared to other histologies. Age and body mass index did not correlate with site of PR.Conclusion:RTCT seems to reduce the rate of systemic PR compared to RT after induction CT in Stage III NSCLC. It is not yet possible to predict which patients will benefit from which type and amount of additional CT.