Factors affecting survival time after recurrence of non-small-cell lung cancer treated with concurrent chemoradiotherapy

Purpose Dose-fractionation schedules of palliative or salvage radiotherapy (RT) for recurrence of non-small-cell lung cancer (NSCLC) are various because they highly depend on patient prognosis. For optimal selection of dosefractionation schedules, factors affecting survival time after recurrence were examined. Materials and methods From 1992 to 2005, 115 patients with stage III NSCLC received curative-intent concurrent chemoradiotherapy (CCRT). Among these patients, 74 underwent recurrence and were reviewed. Evaluated factors were age at recurrence, gender, initial stage, histological subtype, initial radiation-field size, recurrent patterns (locoregional alone vs. distant ± locoregional), time to recurrence (≤6 vs. >6 months), and treatment for recurrence (chemotherapy, RT). Results Median follow-up time after recurrence was 7 (range 0-59) months. One- and 2-year overall survival rates after recurrence were 28 and 11%, respectively. Based on multivariate analysis, time to recurrence (p = 0.0001) and administration of chemotherapy for recurrence (p = 0.0190) were the independently significant factors. Conclusions Early recurrence was the most significant factor for survival after post-CCRT recurrence of NSCLC. Administration of chemotherapy for recurrence was also a significant factor, whereas RT for recurrence was not significant. When RT was given to patients with post-CCRT recurrence of NSCLC, dose-fractionated schedules should be determined considering these factors.