The effect of radiotherapy dose on survival in stage iii non-small-cell lung cancer patients undergoing definitive chemoradiotherapy

Abstract Background In this study, we examined trends in the radiotherapy dose prescribed and the effect of dose escalation on survival in patients with stage III lung cancer. Materials and Methods Radiation dose prescription patterns were analyzed for 38,848 patients in the National Cancer Database with clinical stage III disease who underwent concurrent chemoradiation between 2004 and 2011 to a dose between 57 and 80 Gy. Survival information was available for patients diagnosed from 2004 to 2006 (n = 12,024). Overall survival (OS) was estimated using Kaplan-Meier methods. Cox proportional hazard regression was used to estimate hazard ratios (HRs). Results The percentage of patients treated to ≥ 64 Gy increased from 50% in 2004 to 62% in 2011 ( P P 59.4 Gy compared with the 74 to 80 Gy cohort. Conclusion There was no improvement in OS with radiotherapy dose escalation beyond 59.4 Gy for patients with unresectable clinical stage III lung cancer treated with chemoradiation.