Table 1.
Description of trials
| Trials | Inclusion period | Start of thoracic radiation (day) | RT dose (Gy)/fraction/duration (weeks) | CT (mg/m2) | Number of CT cycles (before RT, during RT, after RT) | Number of patients randomized$a | Median follow-up (years) |
|---|---|---|---|---|---|---|---|
| Earlier versus later radiotherapy | |||||||
| CALGB8083 [25] | 1981–84 | EoS: Day 1 LoL: Day 64 |
50 Gy/24 fr/5 weeks | C: 1000 mg/m2, every 3 weeks V: 1.4 mg/m2, every 3 weeks E: 80 × 3 mg/m2 every 3 weeks Starting at cycle 7 for odd-numbered cycles: C: 1000 mg/m2, every 3 weeks V: 1.4 mg/m2, every 3 weeks A: 50 mg/m2, every 3 weeks |
About 26 cycles EoS: 2 cycles during RT, up to 24 cycles after RT LoL: 3 cycles before RT, 2 cycles during RT, up to 21 cycles after RT |
292 | 17.2 |
| BR.6 [26] | 1985–88 | EoS: Day 22 LoL: Day 106 |
40 Gy/15 fr/3 weeks | EoS: P: 25 mg/m2 × 3 days, weeks4,11,17 E: 100 mg/m2 × 3 days, weeks4,11,17 alternating with C: 1000 mg/m2, weeks1,8,14 A: 50 mg/m2, weeks1,8,14 V: 2 mg, weeks1,8,14 LoL: P: 25 mg/m2 × 3 days, weeks4,10,16 E: 100 mg/m2 × 3 days, weeks4,10,16 alternating with C: 1000 mg/m2, weeks1,7,13 A: 50 mg/m2, weeks1,7,13 V: 2 mg, weeks1,7,13 |
EoS: 6 cycles (1 before RT, 1 during RT, 4 after RT) LoL: 6 cycles (5 before RT, 1 during RT) |
332 | 11.2 |
| EORTC08877 [27] | 1989–95 | EoS: Day 43 LoL: Day 99 |
EoS: 12.5 Gy/5 fr/1 week + break 3 weeks + 12.5 Gy/5 fr/1 week + break 3 weeks + 12.5 Gy/5 fr/1 week + break 3 weeks + 12.5 Gy/5 fr/1 week LoL: 50 Gy/20 fr/4 weeks |
EoS: C: 1000 mg/m2, weeks1,5,9,13,17 A: 45 mg/m2 weeks1,5,9,13,17 E: 100 × 3 mg/m2 weeks1,5,9,13,17 LoL: C: 1000 mg/m2 weeks1,4,7,10,13 A: 45 mg/m2 weeks1,4,7,10,13 E: 100 × 3 mg/m2, weeks1,4,7,10,13 |
EoS: 5 cycles (1 before RT, 4 alternating with RTb) LoL: 5 cycles (5 before RT) |
349 | 7.2 |
| JCOG9104 [28] | 1991–95 | EoS: Day 2 LoL: Day 85 |
45 Gy/30 fr/3 weeks bid | EoS: P: 80 mg/m2, weeks1,5,9,13 E: 100 × 3 mg/m2, weeks1,5,9,13 LoL: P: 80 mg/m2, weeks1,4,7,10 E: 100 × 3 mg/m2, weeks1,4,7,10 |
EoS: 4 cycles (1 during RT, 3 after RT) LoL: 4 cycles (4 before RT) |
231 | 6.8 |
| LLCG93 [12] | 1993–99 | EoS: Day 22 LoL: Day 106 |
40 Gy/15 fr/3 weeks | P: 25 × 3 mg:m2, weeks4,10,16 E: 100 × 3 mg/m2, weeks4,10,16 alternating with C: 1000 mg/m2, weeks1,7,13 A: 50 mg/m2, weeks1,7,13 V: 2 mg, weeks1,7,13 |
EoS: 6 cycles (1 before RT, 1 during RT, 4 after RT) LoL: 6 cycles (5 before RT, 1 during RT) |
325 | 5.3 |
| HeCOG93 [29] | 1993–99 | EoS: Day 1 LoL: Day 57 |
45 Gy/30 fr/3 weeks bid | Cb: 6 AUC, weeks1,4,7,10,13,16 E: 100 × 3 mg/m2, weeks1,4,7,10,13,16 |
EoS: 6 cycles (1 during RT, 5 after RT) LoL: 6 cycles (3 before RT, 1 during RT, 2 after RT) |
81 | 11.8 |
| Trials | Inclusion period | Start of thoracic radiation (day) | RT dose (Gy)/ fraction/duration (weeks) | CT (mg/m2) | Number of CT cycles (before RT, during RT, after RT) | Number of patients randomizeda | Median follow-up (years) |
| Shorter versus longer radiotherapy duration | |||||||
| CCCWFU62286 [30] | 1987–92 | EoS: Day 1 LoL: Day 8 |
EoS: 50 Gy/25 fr/5 weeks LoL: 20 Gy/8 fr/2 weeks + break 1 week + 20 Gy/8 fr/2 weeks + break 1 week + 10 Gy/4 fr/1 week |
C: 750 mg/m2, weeks7,10,16 A: 60 mg/m2, weeks7,10,16 V: 2 mg, weeks7,10,16 alternating with P: 60 mg/m2, weeks1,4,13 E: 120 × 3 mg/m2, weeks1,4,13 |
EoS: 6 cycles (2 during RT, 4 after RT) LoL: 6 cycles (3 alternating with RT, 3 after RT) |
114 | 17.3 |
| 03PCL88 [31] | 1988–94 | EoS: Day 30 LoL: Day 36 |
EoS: 50 Gy/20 fr/5 weeks LoL: 20 Gy/8 fr/2 weeks + break 2 weeks + 20 Gy/8 fr/2 weeks + break 2 weeks + 15 Gy/6 fr/1.5 weeks |
C: 1000 mg/m2, weeks1,13,17,21 A: 45 mg/m2, weeks1,13,17,21 E: 150 × 2 mg/m2, weeks1,13,17,21 Alternating with C: 1000 mg/m2, weeks5,9 Vd: 3 mg/m2, weeks5,9 E: 150 × 2 mg/m2, weeks5,9 |
EoS: 6 cycles (2 before RT, 1 during RT, 3 after RT) LoL: 6 cycles (2 before RT, 2 alternating with RT, 2 after RT) |
164 | 6.5 |
| ECOG3588 [16] | 1989–92 | Both arms: Day 1 | EoS: 45 Gy/30 fr/3 weeks bid LoL: 45 Gy/ 25 fr/5 weeks |
P: 60 mg/m2, weeks1,4,7,10 E: 120 × 3 mg/m2, weeks1,4,7,10 |
4 cycles (2 during RT, 2 after RT) | 417 | 13.0 |
Trials are chronologically ordered within each category of trials (earlier versus later RT, and shorter versus longer RT).
bid, RT given twice a day; CT, chemotherapy; EoS, ‘earlier or shorter’ radiotherapy; fr, fraction; Gy, Gray; LoL, ‘later or longer’ radiotherapy; RT, radiotherapy; A, adriamycin; C, cyclophosphamide; Cb, carboplatin; E, etoposide; P, cisplatin; V, vincristine; Vd, vindesine; BR, bronchus; CALGB, Cancer and Leukaemia Group B; CCCWFU, Comprehensive Cancer Centre of Wake Forest University; ECOG, Eastern Cooperative Oncology Group; EORTC, European Organisation for Research and Treatment of Cancer; HeCOG, Hellenic Cooperative Oncology Group; JCOG, Japan Clinical Oncology Group; LLCG, London Lung Cancer Group; PCL, Petites Cellules Limitées.
aNumber of patients analysed equals the number of patients randomized, except for the HeCOG trial for which data on 81 patients were available out of the 86 randomized patients.
bPublication [27] stated that ‘RT started […] on the 14th day of the second and subsequent courses of chemotherapy in arm Earlier RT’.