Efficacy of platinum agents for stage III non-small-cell lung cancer following platinum-based chemoradiotherapy: a retrospective study

Eriko Miyawaki, Hirotsugu Kenmotsu, Yasushi Shintani, Ikuo Sekine, Takehito Shukuya, Koichi Takayama, Akira Inoue, Isamu Okamoto, Katsuyuki Kiura, Kazuhisa Takahashi, Nobuyuki Yamamoto, Tomoya Kawaguchi, Etsuo Miyaoka, Ichiro Yoshino, Hiroshi Date

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Platinum-based chemoradiotherapy is the standard treatment for unresectable stage III non-small-cell lung cancer (NSCLC). However, few studies have evaluated the efficacy of subsequent chemotherapy for relapsed NSCLC following platinum-based chemoradiotherapy. This study aimed to evaluate the efficacy of platinum-doublet chemotherapy as a second-line treatment for patients with unresectable stage III NSCLC. Methods: We retrospectively evaluated patients with unresectable stage III NSCLC treated with cytotoxic chemotherapy following platinum-based chemoradiotherapy who were registered in a nationwide registry NSCLC database. Patients were divided into the platinum-doublet chemotherapy (platinum) group and single-agent chemotherapy (non-platinum) group based on the type of second-line chemotherapy. Results: The platinum group (n = 119) showed significantly better overall survival (OS) than the non-platinum group (n = 201) (median OS: 21.5 vs. 10.5 months, hazard ratio [HR]: 0.54, 95% confidence interval [CI]: 0.40–0.73, p < 0.001). OS from the beginning of chemoradiotherapy was also significantly better in the platinum group than in the non-platinum group (median OS: 34.9 vs. 21.8 months, HR: 0.58, 95% CI: 0.43–0.79, p = 0.001). In the multivariate analysis, platinum-doublet chemotherapy as second-line therapy, female sex, clinical stage IIIA, and duration of ≥ 8.6 months from the beginning of first-line therapy to the beginning of second-line therapy were associated with significantly better OS. Conclusion: Platinum-doublet chemotherapy as a second-line therapy may prolong survival in unresectable stage III NSCLC patients following platinum-based chemoradiotherapy. Thus, re-administration of platinum agents may be a promising treatment for unresectable stage III NSCLC treated with platinum-based chemoradiotherapy.

Original languageEnglish
Article number342
JournalBMC cancer
Volume22
Issue number1
DOIs
Publication statusPublished - Dec 2022
Externally publishedYes

Keywords

  • Cytotoxic chemotherapy
  • Platinum-based chemotherapy
  • Second-line setting
  • Single-agent chemotherapy
  • Survival

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

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