Clinical question:What is the optimal treatment approach for patients with stage III inoperable NSCLC who, because of patient or tumour factors, are not suitable for curative treatment with concurrent chemo-radiotherapy?/Table

Back to content

Randomised controlled trials comparing different palliative RT regimens in locally advanced NSCLC

Study	N	Performance status	Stage	Palliative RT regimens	Results
Teo et al 1988	291		Inoperable advanced	A. 45Gy/18f (5f/week) v B. 31.2Gy/4f (1f/week)	·         MS (nsig) ·         Symptom palliation A 71%  v B 54% (p<0.02)
Abratt et al 1995	84	0-2	Stage III, too extensive for radical RT	A.      35Gy/10f(5f/week) v B.      45Gy/15f(5f/week)	·         No stat sig difference in survival or symptom palliation
MRC LU13 1996	509	0-2	Inoperable advanced, not metastatic, too extensive for radical RT	(F2)17Gy/2f (1f/week)   v  (F13)39Gy/13f(5f/week) (36Gy/12f)*	·         MS (F2)7m v (F13)9m (p=0.03) ·         More rapid palliation in F2
Rees et al 1997	216	0-3	Not suitable for radical therapy	A.      17Gy/2f(1f/week) B.      22.5/5f (5f/week)	·         Symptom palliation No stat sig difference
Reinfuss et al 1999	240		III unresectable asymptomatic	A.50Gy/25f (5f/week) v B. 20Gy/5f x2 (4week break) C. 20-25Gy/4-5f when symptoms developed	·         Ms A 12m v B 9m v C 6m (sig) ·         2YrS A 18% v B 6% v C 0% (sig)
Nestle et al 2000	152		III/IV	A.60Gy/30f (5f/week) v B. 32Gy/16f (2f/day)	No stat sig difference in survival or symptom palliation.
Bezjak et al 2002	230		III unsuitable for curative treatment, IV	A.10Gy/1f v B. 20Gy/5f	·         Symptom palliation B: Stat sig improvement in symptoms related to lung cancer, pain, ability to carry out normal activities and global quality of life. ·         MS B: survived 2 m longer (p=.0305)
Sundstrom et al 2004	421		Locally advanced Stage III/IV, Not suitable for curative therapy	A.17Gy/2f (1/week) B.42Gy/15f(5f/week) C. 50Gy/25f (5f/week)	·         Symptom palliation No stat sig diff between arms ·         MS No stat sig difference
Erridge et al 2005	149	0-3	Symptomatic lung cancer not amenable to curative therapy	A.      10Gy/1f v B.      30Gy/10f	Two regimens equivalent but sig more patients in B achieved complete resolution of symptoms and palliation
Kramer et al 2005	297	ECOG PS 3-4+/- substantial weight loss	Stage IIIA/B Stage IV	A.      16Gy/2f v B.      30Gy/10f	·         1yr S A10.9%vB19.6% (p=0.03) ·         Symptom palliation more prolonged in B
Senkus-Konefka 2005	100			A.20Gy/5f(5f/w) v B. 16Gy/2f	·         OS A5.3m v B 8.0m (p=0.016) ·         Symptom palliation Ns difference between arms