Radical Radiotherapy for Locally Advanced Non-small Cell Lung Cancer: When Should Concurrent Chemoradiotherapy Not Be Used?

D. De Ruysscher*, J. van Loon

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Concurrent chemotherapy and radiotherapy confers a significant, but small, benefit for overall survival compared with sequential chemoradiotherapy. The improvement of about 4% with a hazard ratio of 0.85 has only been proven for fit patients with a good organ function. From non-randomised trials, there are no indications that concurrent chemoradiotherapy is clearly superior to the sequential approach in other patients. Moreover, radiotherapy alone can lead to 5 year survival rates of 20%. As the differences in long-term survival between the treatment options are small, even fit patients should be offered, via a shared decision process, the choice between concurrent and non-concurrent chemotherapy and radiotherapy. In less fit patients, sequential chemoradiotherapy offers a chance for long-term survival and cure with less toxicity than the concurrent approach.
Original languageEnglish
Pages (from-to)708-711
JournalClinical oncology
Issue number11
Publication statusPublished - Nov 2016


  • Combined modality treatment
  • concurrent
  • elderly
  • frail
  • non-small cell lung cancer
  • sequential

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