Clinical impact of post-progression survival in patients with locally advanced non-small cell lung cancer after chemoradiotherapy.

Background: The efficacy of first-line chemoradiotherapy for overall survival (OS) might be confounded by the subsequent treatments in patients with locally advanced non-small cell lung cancer (NSCLC). In this study, we assessed the associations of progression-free survival (PFS) and post-progression survival (PPS) with OS after chemoradiotherapy for locally advanced NSCLC using patient-level data.

Patients And Methods: Between January 2011 and December 2018, 45 patients with locally advanced NSCLC who had received first-line chemoradiotherapy and in whom recurrence occurred were analysed. The associations of PFS and PPS with OS were analysed at the individual level.

Results: Linear regression and Spearman rank correlation analyses revealed that PPS was strongly correlated with OS ( = 0.72, < 0.05, 2 = 0.54), whereas PFS was moderately correlated with OS ( = 0.58, < 0.05, = 0.34). The Glasgow prognostic score and liver metastases at recurrence were significantly associated with PPS ( < 0.001).

Conclusions: The current analysis of individual-level data of patients treated with first-line chemoradiotherapy implied that PPS had a higher impact on OS than PFS in patients with locally advanced NSCLC. Additionally, current perceptions indicate that treatment beyond progression after first-line chemoradiotherapy might strongly affect OS.