Research Article

Comparison of Involved Field Radiotherapy versus Elective Nodal Irradiation in Stage IIIB/C Non-Small-Cell Lung Carcinoma Patients Treated with Concurrent Chemoradiotherapy: A Propensity Score Matching Study

Table 3

Toxicity and survival outcomes according to elective nodal irradiation status.

OutcomeENI (N = 323)IFRT (N = 323) value

Acute grade 3-4 hematologic toxicity, n (%)
 Leukopenia51 (15.7)32 (9.9)0.012
 Anemia23 (7.1)14 (4.3)0.14
 Thrombocytopenia41 (12.7)30 (9.3)0.32

Acute grade 3 nonhematologic toxicity, n (%)
 Nausea-vomiting109 (33.7)67 (20.7)0.006
 Esophagitis49 (15.2)29 (9.0)0.003
 Pneumonitis47 (14.5)27 (8.4)0.002
 Peripheric neuropathy10 (3.1)11 (3.4)0.76
 Pericarditis5 (1.5)2 (0.6)0.25

Late grade 3-4 toxicity
 Lung12 (3.7)9 (2.8)0.34
 Esophagus15 (4.6)8 (2.5)0.038
 Heart5 (1.5)3 (0.9)0.78
 Major vessels3 (0.9)2 (0.6)0.64

Late grade 5 toxicity, n (%)6 (1.8)4 (1.2)0.73
 Radiation pneumonitis2 (0.6)1 (0.3)
 Tracheoesophageal fistula2 (0.6)1 (0.3)
 Bronchopleural fistula1 (0.3)1 (0.3)
 Aortic blow-out1 (0.3)1 (0.3)

Hospitalization, n (%)58 (18.0)28 (8.6)<0.001

PFS
 Median, mo11.7 (10.8–12.6)11.2 (10.2–12.4)0.57
 5-years (%)12.111.6
 10 years (%)6.25.2

LRPFS
 Median, mo15.3 (14.3–16.3)15.1 (14.1–16.1)0.52
 5-years (%)13.513.3
 10 years (%)7.25.8

OS
 Median, mo25.2 (23.5–26.3)24.6 (22.6)-26.60.69
 5-year (%)22.221.2
 10 year (%)11.911.1

5-year in-field failure, n (%)
 Local127 (39.3)125 (38.7)0.79
 Regional64 (19.8)59 (18.3)0.44
 Local + regional57 (17.6)61 (18.9)0.56

Isolated ENF
 5-years (%)11 (3.4)14 (4.3)0.52
 10 years (%)16 (4.9)19 (5.9)0.71

ENI: elective nodal irradiation; IFRT: involved-field radiotherapy; PFS: progression-free survival; LRPFS: locoregional progression-free survival; OS: overall survival; ENF: elective nodal failure.