***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: As concomitant chemoradiotherapy for stage III NSCLC is associated with survival advantage in comparison to a sequential approach , we conducted a phase III r and omised study aim ing to determine the best sequence and safety of chemotherapy ( CT ) and chemoradiotherapy ( CT-RT ) , using a regimen with cisplatin ( CDDP ) , gemcitabine ( GEM ) and vinorelbine ( VNR ) .  Unresectable stage III NSCLC patients received CDDP ( 60 mg/m(2 ) ) , GEM ( 1g/m(2 ) , days 1 and 8) and VNR ( 25mg/m(2 ) , days 1 and 8) with reduced dosage of GEM and VNR during radiotherapy ( 66Gy ) . Two cycles of CT with radiotherapy followed by two further cycles of CT alone were administered in arm A or the reverse sequence in arm B. The study was prematurely closed for poor accrual due to administrative problems . Forty-nine eligible patients were r and omised .  Response rates and median survival times were , respectively 57 % ( 95 % CI : 36 - 78 % ) and 17 months ( 95 % CI : 9.3 - 24.6 months ) in arm A and 79 % ( 95 % CI : 64 - 94 % ) and 23.9 months ( 95 % CI : 13.3 - 34.5 months ) in arm B ( p>0.05 ) . Chemotherapy dose-intensity was significantly reduced in arm A. Grade 3 - 4 oesophagitis occurred in 5 patients . One case of grade 5 radiation pneumonitis was observed . In conclusion , chemoradiotherapy with CDDP , GEM and VNR appears feasible as initial treatment or after induction chemotherapy . Consolidation chemoradiotherapy seems less toxic with a better observed response rates and survival although no valid conclusion can be drawn from the comparison of both arms PURPOSE We conducted a phase III study to compare the survival impact of concurrent versus sequential treatment with radiotherapy ( RT ) and chemotherapy ( CT ) in unresectable stage III non-small-cell lung cancer ( NSCLC ) . PATIENTS AND METHODS Patients were r and omly assigned to one of the two treatment arms . In the sequential arm , patients received induction CT with cisplatin ( 120 mg/m2 ) on days 1 , 29 , and 57 , and vinorelbine ( 30 mg/m2/wk ) from day 1 to day 78 , followed by thoracic RT at a dose of 66 Gy in 33 fractions ( 2 Gy per fraction and 5 fractions per week ) . In the concurrent arm , the same RT was started on day 1 with two concurrent cycles of cisplatin 20 mg/m2/d and etoposide 50 mg/m2/d ( days 1 to 5 and days 29 to 33 ) ; patients then received consolidation therapy with cisplatin 80 mg/m2 on days 78 and 106 and vinorelbine 30 mg/m2/wk from days 78 to 127 . RESULTS Two hundred five patients were r and omly assigned . Pretreatment characteristics were well balanced between the two arms . There were six toxic deaths in the sequential arm and 10 in the concurrent arm . Median survival was 14.5 months in the sequential arm and 16.3 months in the concurrent arm ( log-rank test P = .24 ) . Two- , 3- , and 4-year survival rates were better in the concurrent arm ( 39 % , 25 % , and 21 % , respectively ) than in the sequential arm ( 26 % , 19 % , and 14 % , respectively ) . Esophageal toxicity was significantly more frequent in the concurrent arm than in the sequential arm ( 32 % v 3 % ) . CONCLUSION Although not statistically significant , clinical ly important differences in the median , 2- , 3- , and 4-year survival rates were observed , with a trend in favor of concurrent chemoradiation therapy , suggesting that is the optimal strategy for patients with locally advanced NSCLC The optimal schedule and regimen of chemotherapy ( CT ) in association with chemoradiation has not been established in stage III non-small-cell lung cancer ( NSCLC ) . We have compared three schedules of non-platinum-based CT plus either radiotherapy or chemoradiation . From May 2001 to June 2006 , 158 patients with unresectable stage III NSCLC were enrolled in a r and omized phase II trial with overall response rate ( ORR ) as the primary endpoint . The initial design included three arms : sequential CT followed by thoracic radiation ( TRT ) ; concurrent CT/TRT followed by consolidation CT ; and induction CT followed by concurrent CT/TRT . However , based on the preliminary results of the RTOG 9410 trial , the sequential arm was closed when 19 patients had been enrolled . All patients received two cycles of docetaxel 40 mg/m(2 ) days 1 and 8 plus gemcitabine 1200 mg/m(2 ) days 1 and 8 , as either induction or consolidation therapy . Concurrent CT/TRT consisted of docetaxel 20 mg/m(2 ) and carboplatin AUC 2 weekly plus 60 Gy TRT . No differences were found in ORR between the two arms ( 56 % and 57 % ) . Hematological toxicity was mild but significantly superior with consolidation CT ; the esophagitis rate was similar in both arms ( 16 % and 15 % ) . With a median follow-up of 57 months , no differences were found in median survival ( 13.07 and 13.8 months ) or 5-year survival ( 16.4 % and 22 % ) . This regimen can not be recommended as an alternative to platinum-based CT/TRT although it has an acceptable toxicity profile and encouraging long-term survival data ( Clinical Trials.gov NCT01652820 ) Introduction : The aim of this multicenter phase II trial was to evaluate the combination of oral vinorelbine and cisplatin with radiotherapy ( RT ) after cisplatin-docetaxel induction chemotherapy ( CT ) in patients with locally advanced non-small cell lung cancer ( NSCLC ) . Patients and Methods : Patients with previously untreated , inoperable , histologically or cytologically confirmed stage IIIA or IIIB NSCLC , with performance status ≤1 and weight loss ≤10 % received two cycles of induction CT with cisplatin ( 75 mg/m2 ) and docetaxel ( 75 mg/m2 ) every 3 weeks . Patients with a tumor response or stabilization continued to receive cisplatin ( 80 mg/m2 ) and oral vinorelbine ( 40 mg/m2 ) on days 1 and 8 for two cycles , with concomitant thoracic RT ( 2 Gy/d , 5 d/wk , and total dose 66 Gy ) . Results : Fifty-six patients were enrolled . All patients ( n = 38 ) who received CT-RT were assessable for the tumor response . There were no complete responses . In the intent-to-treat analysis , the response rates were 32.1 % after induction CT and 41.1 % after CT-RT . The median progression-free and overall survival times were 9.2 months ( 95 % confidence interval : 7–14 ) and 20.8 months ( 95 % confidence interval : 13.7–24.1 ) , respectively . Adverse effects of RT-CT were grade s 3 to 4 neutropenia ( four patients ) and grade 3 esophageal toxicity ( one patient ) . No treatment-related deaths occurred . Conclusion : The oral vinorelbine-cisplatin combination with concurrent RT is feasible and has a favorable risk-benefit ratio in stage IIIA/IIIB NSCLC PURPOSE This phase II noncomparative r and omized trial was conducted to determine the optimal sequencing and integration of paclitaxel/carboplatin with st and ard daily thoracic radiation therapy ( TRT ) , in patients with locally advanced unresected stage III non-small-cell lung cancer ( NSCLC ) . Survival data were compared with historical st and ard sequential chemoradiotherapy data from the Radiation Therapy Oncology Group . PATIENTS AND METHODS Patients with unresected stages IIIA and IIIB NSCLC , with Karnofsky performance status > or = 70 % and weight loss < or = 10 % , received two cycles of induction paclitaxel ( 200 mg/m2)/carboplatin ( area under the plasma concentration time curve [ AUC ] = 6 ) followed by TRT 63.0 Gy ( arm 1 , sequential ) or two cycles of induction paclitaxel ( 200 mg/m2)/carboplatin ( AUC = 6 ) followed by weekly paclitaxel ( 45 mg/m2)/carboplatin ( AUC = 2 ) with concurrent TRT 63.0 Gy ( arm 2 , induction/concurrent ) , or weekly paclitaxel ( 45 mg/m2)/carboplatin ( AUC = 2)/TRT ( 63.0 Gy ) followed by two cycles of paclitaxel ( 200 mg/m2)/carboplatin ( AUC = 6 ; arm 3 , concurrent/consolidation ) . RESULTS With a median follow-up time of 39.6 months , median overall survival was 13.0 , 12.7 , and 16.3 months for arms 1 , 2 , and 3 , respectively . During induction chemotherapy , grade 3/4 granulocytopenia occurred in 32 % and 38 % of patients on study arms 1 and 2 , respectively . The most common locoregional grade 3/4 toxicity during and after TRT was esophagitis , which was more pronounced with the administration of concurrent chemoradiotherapy on study arms 2 and 3 ( 19 % and 28 % , respectively ) . CONCLUSION Concurrent weekly paclitaxel , carboplatin , and TRT followed by consolidation seems to be associated with the best outcome , although this schedule was associated with greater toxicity This is phase II study evaluating a non-platinum-containing regimen , used in conjunction with radiotherapy , in patients with locally advanced non-small cell lung cancer ( NSCLC ) . Patients with non-resectable stage III NSCLC were treated with two cycles of induction gemcitabine ( 1000mg/m(2 ) ) and vinorelbine ( 25mg/m(2 ) ) given on D(1,8 ) every 21 days , followed by thoracic radiotherapy ( 60 - 66Gy ) with concurrent weekly vinorelbine ( 15mg/m(2 ) ) . The primary objective was to assess response rate and secondary objectives to assess tolerability and to determine the progression-free survival ( PFS ) and overall survival ( OS ) . Of the 42 patients enrolled on the study , 15 ( 36 % ) achieved a partial response ( PR ) after induction chemotherapy . After chemo-radiotherapy , five patients had complete response ( CR ) and 19 patients had PR , giving an overall response rate of 52 % . The median PFS was 8 months and median OS was 17 months . The regimen was tolerable , with a 21 % grade 3/4 neutropenia rate and 38 % grade 2/3 esophagitis rate PURPOSE St and ard therapy for unresectable stage III non-small-cell lung cancer includes concomitant chemoradiotherapy . In Cancer and Leukemia Group B 39801 , we evaluated whether induction chemotherapy before concurrent chemoradiotherapy would result in improved survival . PATIENTS AND METHODS Between July 1998 and May 2002 , 366 patients were r and omly assigned to arm A , which involved immediate concurrent chemoradiotherapy with carboplatin area under the concentration-time curve ( AUC ) of 2 and paclitaxel 50 mg/m2 given weekly during 66 Gy of chest radiotherapy , or arm B , which involved two cycles of carboplatin AUC 6 and paclitaxel 200 mg/m2 administered every 21 days followed by identical chemoradiotherapy . The accrual goal was 360 patients . RESULTS Thirty-four percent of patients were female , 66 % were male , and the median age was 63 years .  Grade 3 or 4 toxicities during induction chemotherapy on arm B consisted mainly of neutropenia ( 18 % and 20 % , respectively ) . During concurrent chemoradiotherapy , there was no difference in severity of in-field toxicities of esophagitis ( grade 3 and 4 were , respectively , 30 % and 2 % for arm A v 28 % and 8 % for arm B ) and dyspnea ( grade 3 and 4 were , respectively , 11 % and 3 % for arm A v 15 % and 4 % for arm B ) . Survival differences were not statistically significant ( P = .3 ) , with a median survival on arm A of 12 months ( 95 % CI , 10 to 16 months ) versus 14 months ( 95 % CI , 11 to 16 months ) on arm B and a 2-year survival of 29 % ( 95 % CI , 22 % to 35 % ) and 31 % ( 95 % CI , 25 % to 38 % ) . Age , weight loss before therapy , and performance status were statistically significant predictive factors . CONCLUSION The addition of induction chemotherapy to concurrent chemoradiotherapy added toxicity and provided no survival benefit over concurrent chemoradiotherapy alone . The median survival achieved in each of the treatment groups is low , and 
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Our analysis also indicated that induction chemotherapy was as effect as consolidation chemotherapy for patients who received CCRT on overall response and OS .
Conclusion : Five year OS could be improved when induction chemotherapy was added into CCRT for patients of NSCLC .
Except low rate of leucopenia , induction chemotherapy was no difference compared to consolidation chemotherapy in patients with NSCLC treated by CCRT