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Concurrent vs Sequential CRT — SCE Medical Oncology MCQ

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EasyLung CancerConcurrent vs Sequential CRTSCE Medical Oncology

A 62-year-old man with NSCLC is being counselled about concurrent versus sequential chemoradiotherapy for unresectable stage III disease. He has ECOG PS 1 and good lung function. What is the key difference in outcomes?

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Correct answer: D — Concurrent chemoradiation improves OS by approximately 5-6% at 5 years compared with sequential CRT

The RTOG 9410 and Auperin et al meta-analysis established that concurrent chemoradiation improves OS (~5-6% at 5 years) compared with sequential delivery for unresectable stage III NSCLC in fit patients. The benefit derives from the radiosensitising effect of concurrent platinum-based chemotherapy. The trade-off is increased acute toxicity (grade 3+ oesophagitis ~18% vs ~4%, grade 3+ pneumonitis ~4%). Patient selection (PS 0-1, adequate lung function) is critical.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer