Background and Objective: Based on retrospective trials, most progression\nsites after first line systemic therapy for metastatic non small cell lung cancer\n(NSCLC) were the primary disease sites rather than new sites. Therefore we\nconducted phase II randomized study to determine whether oligometastatic\nNSCLC without disease progression after first line chemotherapy, have prolonged\nprogression free survival when treated with local consolidation therapy\nof residual disease followed by surveillance compared with no local consolidation\ntherapy (observation). Patients and Methods: Forty eight eligible\npatients were randomized to either immediate or no local consolidation radiotherapy.\n26 patients of immediate local consolidation radiotherapy received\n3 D-conformal radiation therapy to primary tumor site and metastatic sites of\ndisease. 22 patients were followed up by observation. Results: Patients in local\nconsolidation arm had significantly better progression free survival (PFS)\ncompared with patients in observation group. Median PFS was 9.5 months\n(95% CI 7.8 - 11.08) in local consolidation arm and 4.5 months (95%CI 3.9 -\n5.7) in observation arm. Patients in local consolidation arm had longer median\ntime to appearance of new metastatic sites (10 months CI 9.3 - 12.6)\nthan those patients in observation arm (4.5 months CI 4.2 - 6.9). Median\noverall survival (OS) of patients in local consolidation arm was 12 months\n(95% CI 12.1 - 18.01) and in observation arm 10 months (95% CI 8.7 - 13.8).\nOne year OS rate was 42.3% in local consolidation arm and 31.8% in observation\narm; 2 year OS rate was 23.1% in local consolidation arm and only 4.5%\nin observation arm. Conclusion: Local consolidation radiotherapy is simple,\nsafe, efficient, and not expensive treatment for oligometastatic non small cell lung cancer after upfront chemotherapy. Local consolidation radiotherapy\nachieved significantly prolonged progression free survival and delayed appearance\nof new metastatic sites. Phase III studies are recommended to test\nbenefit of local consolidation radiotherapy to gain prolonged progression free\nsurvival and overall survival. Also, define optimal patientsâ?? subgroups that are\nmore likely to benefit of local consolidation radiotherapy.
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