Clinical Outcomes in Long-Term Survivors of Lung Cancer Treated with Definitive Chemoradiation

Chemoradiotherapy is the standard treatment for unresectable, locally advanced lung cancer. With the commencement of durvalumab as an adjuvant therapy, increased number of long-term survivors is anticipated. However, the prognosis of long-term survivors and appropriate follow-up remains largely unknown. Using real-world long-term data before durvalumab, this study aimed to evaluate the prognosis and incidence of metachronous cancer among patients with non-small cell lung cancer (NSCLC) who survived for longer than 5 years after chemoradiotherapy at our institution. We retrospectively analyzed the data of patients with stage III (Union for International Cancer Control 6 th ) NSCLC who underwent chemoradiotherapy for curative intent at our institution from 2003 to 2017. Survival and cumulative incidence were estimated using the Kaplan–Meier method. In total, 147 patients were included in this study. Among them, 40 survived for longer than 5 years. The estimated 5-year survival rate was 31.2% (95% confidence interval [CI]: 23.7–39.2%), and 25 patients were then recurrence-free. The median survival period for patients who survived for longer than 5 years was 5.32 years (95% CI 3.91–6.21 years). Among these patients, 10 died of primary lung cancer and nine from metachronous cancers, particularly esophageal (n=3) and lung (n=4) cancers. The prognosis of long-term survivors after curative chemoradiotherapy extends beyond 5 years. However, follow-up, focusing attention on the occurrence of metachronous cancer, is necessary. Routine surveillance, including chest computed tomography and upper endoscopy, may aid in the early detection of metachronous cancers