Abstract: Concurrent or Sequential Gemcitabine Combined with Radiotherapy for Locally AdvancedNon-Small Cell Lung CancerJietao MA Chengbo HAN Huawei ZOUCorrespondence to: Jietao MA, E-mail: ma_jt@126.comDepartment of Oncology, Shengjing Hospital Affiliated to China Medical University, Shenyang 110004, ChinaThis work was supported by National Natural Science Foundation of China (No.30700979)Abstract Objective: To compare the toxicity and efficacy of concurrent or sequential Gemcitabine combined with radiotherapyfor locally advanced non-small cell lung cancer. Methods: Fifty-six patients with pathologically diagnosed locally advanced non-surgi-cal Ⅲ a/Ⅲ b non-small cell lung cancer ( NSCLC ), KPS ≥ 70, received 2 cycles of induction chemotherapy ( CT ), induced gemcitabi-ne ( G ) and cisplatin ( P ), and were non-randomly divided into two groups. The sequential chemotherapy and radiotherapy (SCRT)group included 26 cases that received 2 additional cycles of consolidation chemotherapy induced GP after radiotheraphy; the concurrentchemotherapy and radiotherapy ( CCRT ) group included 30 cases that received concurrent chemotherapy induced G, followed by 2 cy-cles of consolidation chemotherapy. Induction and consolidation chemotherapy regimens: gemcitabine ( Gemzar ) 1000 mg/m2d1, d8,cisplatin 25 mg/m2d1~3, q21d; concurrent chemotherapy: gemcitabine 600 mg/m2weekly, all patients received three-dimensional con-formal radiotherapy ( 3DCRT ), total dose DT60～ 66Gy/30 ~ 33f / 6 ~ 6.5w. The efficacy, toxicity, and long-term survival of the twogroups were evaluated. Results: The median follow-up was 18.5 months. For the SCRT group compared to the CCRT group: the objec-tive response rate ( ORR ) was 53.85% vs. 73.33% ( P > 0.05 ); the median progression-free survival ( mPFS ) was 9.18 months ( 95%CI, 8.09-10.26 months ) vs. 11.31 months ( 95% CI, 10.35-12.26 months ) ( P < 0.05 ); the 1-year survival rate was 61.5% vs. 80.0%and the 2-year survival rate was 23.08% vs. 46.67% ( P > 0.05 ); the median survival time was 14.6 months vs. 19.2 months ( P <0.05 ). Common treatment-related adverse events (AEs) included marrow suppression, radiation esophagitis and radiation pneumonitis.The rate of grade 3/4 neutropenia was 23.08% vs 26.67% ( P > 0.05 ), grade 3/4 thrombocytopenia 23.08% vs 23.34% ( P > 0.05 ),grade 3/4 radiation esophagitis 19.23% vs 23.33%, grade 3/4 radioactive pneumonia 15.39% vs 26.67% ( P > 0.05 ). Conclusion: Con-current treatment with gemcitabine and radiotherapy for locally advanced non-small cell lung cancer tends to have better results than se-quential therapy, and the increased toxicity can be better tolerated.Keywords Non small cell lung cancer; Gemcitabine; Chemoradiotherapy; Concurrent; Sequential