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KMID : 0859320060240040230
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Journal of the Korean Society for Therapeutic Radiology and Oncology
2006 Volume.24 No. 4 p.230 ~ p.236
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Treatment Outcome of Locally Advanced Non-small Cell Lung Cancer Patients Who Received Concurrent Chemoradiotherapy
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Kim Su-Zy
Cho Deog-Gon
Song So-Hyang
Cho Kyu-Do
Kim Chi-Hong
Kim Sung-Hwan
Shim Byoung-Yong
Ahn Meyung-Im
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Abstract
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Purpose: To analyze the response, toxicity, patterns of failure and survival rate of patients with locally advanced non-small cell lung cancer who were treated with concurrent chemoradiotherapy with weekly paclitaxel.
Materials and Methods: Twenty-three patients with locally advanced non-small cell lung cancer patients who received radical chemoradiotherapy from October 1999 to September 2004 were included in this retrospective study. Patients received total 55.4～64.8 (median 64.8) Gy (daily 1.8 Gy per fraction, 5 days per weeks) over 7～8 weeks. 50 or 60 mg/m2 of paclitaxel was administered on day 1, 8, 15, 22, 29 and 36 of radiotherapy. Four weeks after the concurrent chemoradiotherapy, three cycles of consolidation chemotherapy consisted of paclitaxel 135 mg/m2 and cisplatin 75 mg/m2 was administered every 3 weeks.
Results: < b>Of the 23 patients, 3 patients refused to receive the treatment during the concurrent chemoradiotherapy. One patient died of bacterial pneumonia during the concurrent chemoradiotherapy. Grade 2 radiation esophagitis was observed in 4 patients (17%). Sixteen patients received consolidation chemotherapy. During the consolidation chemotherapy, 8 patients (50%) experienced grade 3 or 4 neutropenia and one of those patients died of neutropenic sepsis. Overall response rate for 20 evaluable patients was 90% including 4 complete responses (20%) and 14 partial responses (70%). Among 18 responders, 9 had local failure, 3 had local and distant failure and 2 had distant failure only. Median progression-free survival time was 9.5 months and 2-year progression-free survival rate was 19%. Eleven patients received second-line or third-line chemotherapy after the treatment failure. The median overall survival time was 21 months. 2-year and 5-year survival rate were 43% and 33%, respectively. Age, performance status, tumor size were significant prognostic factors for progression-free survival.
Conclusion: Concurrent chemoradiotherapy with weekly paclitaxel revealed high response rate and low toxicity rate. But local failure occurred frequently after the remission and large tumor size was a poor prognostic factor. Further investigations are needed to improve the local control.
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KEYWORD
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Non-small cell lung cancer, Concurrent Chemoradiotherapy, Paclitaxel
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