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document
Poor prognosis patients with inoperable locally advanced NSCLC and large tumors benefit from palliative chemoradiotherapy : a subset analysis from a randomized clinical phase III trial . INTRODUCTION Poor prognosis patients with bulky stage III locally advanced non-small-cell lung cancer may not be offered concurrent chemoradiotherapy ( CRT ) . Following a phase III trial concerning the effect of palliative CRT in inoperable poor prognosis patients , this analysis was performed to explore how tumor size influenced survival and health-related quality of life ( HRQOL ) . METHODS A total of 188 poor prognosis patients recruited in a randomized clinical trial received four courses intravenous carboplatin day 1 and oral vinorelbine day 1 and 8 , at 3-week intervals . The experimental arm ( N = 94 ) received radiotherapy with fractionation 42 Gy/15 , starting at the second chemotherapy course . This subset study compares outcomes in patients with tumors larger than 7 cm ( N = 108 ) versus tumors 7 cm or smaller ( N = 76 ) . RESULTS Among those with tumors larger than 7 cm , the median overall survival in the chemotherapy versus CRT arm was 9.7 and 13.4 months , respectively ( p = 0.001 ) . The 1-year survival was 33 % and 56 % , respectively ( p = 0.01 ) . Except for a temporary decline during treatment , HRQOL was maintained in the CRT arm , regardless of tumor size . Among those who did not receive CRT , patients with tumors larger than 7 cm experienced a gradual decline in the HRQOL . The CRT group had significantly more esophagitis and hospitalizations because of side effects regardless of tumor size . CONCLUSION In patients with poor prognosis and inoperable locally advanced non-small-cell lung cancer , large tumor size should not be considered a negative predictive factor . Except for performance status 2 , patients with tumors larger than 7 cm apparently benefit from CRT .
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Intervention_Pharmacological
palliative chemoradiotherapy :
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Intervention_Pharmacological
CRT
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Intervention_Pharmacological
intravenous carboplatin
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Intervention_Pharmacological
oral vinorelbine
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Intervention_Pharmacological
radiotherapy with fractionation 42 Gy/15
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Intervention_Pharmacological
chemotherapy
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Intervention_Pharmacological
CRT
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Intervention_Pharmacological
CRT
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Intervention_Pharmacological
CRT
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Intervention_Pharmacological
CRT
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Intervention_Pharmacological
CRT .
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Outcome_Physical
effect
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Outcome_Mortality
survival
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Outcome_Physical
and health-related
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Outcome_Other
quality of life
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Outcome_Physical
( HRQOL )
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Outcome_Physical
compares outcomes in patients with tumors larger than 7 cm ( N = 108 ) versus tumors 7 cm or smaller ( N = 76 )
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Outcome_Mortality
median overall survival
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Outcome_Mortality
1-year survival
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Outcome_Physical
HRQOL
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Outcome_Other
HRQOL
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Outcome_Physical
significantly more esophagitis
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Outcome_Adverse-effects
side effects
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Participant_Condition
Poor prognosis patients with inoperable locally advanced NSCLC and large tumors
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Participant_Condition
Poor prognosis
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Participant_Sample-size
188
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Participant_Sample-size
108
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Participant_Sample-size
76
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Participant_Condition
poor prognosis
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Participant_Condition
inoperable locally advanced non-small-cell lung cancer