PMID- 26163093
OWN - NLM
STAT- MEDLINE
DCOM- 20151116
LR  - 20181202
IS  - 1879-0887 (Electronic)
IS  - 0167-8140 (Linking)
VI  - 116
IP  - 1
DP  - 2015 Jul
TI  - The International Atomic Energy Agency (IAEA) randomized trial of palliative 
      treatment of incurable locally advanced non small cell lung cancer (NSCLC) using 
      radiotherapy (RT) and chemotherapy (CHT) in limited resource setting.
PG  - 21-6
LID - S0167-8140(15)00299-6 [pii]
LID - 10.1016/j.radonc.2015.06.017 [doi]
AB  - BACKGROUND: To optimize palliation in incurable locally advanced non-small cell 
      lung cancer (NSCLC), the International Atomic Energy Agency conducted a 
      prospective randomized study (NCT00864331) comparing protracted palliative 
      radiotherapy (RT) course with chemotherapy (CHT) followed by short-course 
      palliative RT. METHODS AND MATERIALS: Treatment-naive patients with 
      histologically confirmed NSCLC, stage IIIA/IIIB, received either 39Gy in 13 
      fractions as RT alone (arm A, n=31) or 2-3 platinum-based CHT cycles followed by 
      10Gy in a single fraction or 16Gy in 2 fractions separated by one week (arm B, 
      n=34). Primary outcome was overall survival. RESULTS: Treatment groups were 
      balanced with respect to various variables. Median survival for all 65 patients 
      was 8months, while median survival was 7.1 and 8.1months for the two arms, 
      respectively (log-rank p=0.4 by study arm, and p=0.6 by Cox regression and 
      stratified by country and sub-stage). One and three year survival rates for the 
      two arms were 29%, and 9% and 41%, and 6%, respectively. There were no 
      differences in any of the following endpoints: any failure, local failure, 
      regional failure, contralateral thoracic failure, and distant failure between the 
      two arms. High-grade (⩾3) toxicity was similar between the two arms. Symptoms, 
      adverse events of any kind, KPS and body-mass index, were not different during 
      treatment and during follow-up. There was no grade 5 toxicity. CONCLUSIONS: This 
      incomplete and underpowered trial only hinted similar outcome between the 
      treatment arms. Therefore, combined CHT-RT can perhaps be considered, in limited 
      resource setting, where access to RT remains inadequate.
CI  - Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved.
FAU - Jeremic, Branislav
AU  - Jeremic B
AD  - Institute of Lung Diseases, Sremska Kamenica and BioIRC Research Centre, 
      Kragujevac, Serbia. Electronic address: nebareje@gmail.com.
FAU - Fidarova, Elena
AU  - Fidarova E
AD  - International Atomic Energy Agency, Vienna, Austria.
FAU - Sharma, Vinay
AU  - Sharma V
AD  - University of Witswatersrand, Johannesburg, South Africa.
FAU - Faheem, Mohammed
AU  - Faheem M
AD  - Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, Pakistan.
FAU - Ameira, Aly Azmy
AU  - Ameira AA
AD  - Misr Oncology Centre, Cairo, Egypt.
FAU - Nasr Ben Ammar, Chiraz
AU  - Nasr Ben Ammar C
AD  - Institut National de Cancer Salah Azaiz, Tunis, Tunisia.
FAU - Frobe, Ana
AU  - Frobe A
AD  - Sestre Milosrdnice Hospital, Zagreb, Croatia.
FAU - Lau, FeeNee
AU  - Lau F
AD  - General Hospital, Kuala Lumpur, Malaysia.
FAU - Brincat, Stephen
AU  - Brincat S
AD  - Sir Paul Boffa Hospital, La Valetta, Malta.
FAU - Jones, Glenn
AU  - Jones G
AD  - University of Toronto, Canada.
LA  - eng
SI  - ClinicalTrials.gov/NCT00864331
PT  - Clinical Trial, Phase III
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20150707
PL  - Ireland
TA  - Radiother Oncol
JT  - Radiotherapy and oncology : journal of the European Society for Therapeutic 
      Radiology and Oncology
JID - 8407192
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*therapy
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - International Agencies
MH  - Lung Neoplasms/*therapy
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Nuclear Energy
MH  - *Palliative Care
MH  - Prospective Studies
MH  - Survival Rate
OTO - NOTNLM
OT  - Chemotherapy
OT  - International Atomic Energy Agency
OT  - Locally advanced nonsmall cell lung cancer
OT  - Radiotherapy
OT  - Randomized trial
EDAT- 2015/07/15 06:00
MHDA- 2015/11/17 06:00
CRDT- 2015/07/12 06:00
PHST- 2015/03/04 00:00 [received]
PHST- 2015/06/10 00:00 [revised]
PHST- 2015/06/13 00:00 [accepted]
PHST- 2015/07/12 06:00 [entrez]
PHST- 2015/07/15 06:00 [pubmed]
PHST- 2015/11/17 06:00 [medline]
AID - S0167-8140(15)00299-6 [pii]
AID - 10.1016/j.radonc.2015.06.017 [doi]
PST - ppublish
SO  - Radiother Oncol. 2015 Jul;116(1):21-6. doi: 10.1016/j.radonc.2015.06.017. Epub 
      2015 Jul 7.