KMID : 1038620160340030202
|
|
Radiation Oncology Journal 2016 Volume.34 No. 3 p.202 ~ p.208
|
|
Comparison of concurrent chemoradiotherapy versus sequential radiochemotherapy in patients with completely resected non-small cell lung cancer
|
|
Kim Hwan-Ik
Noh O-Kyu Oh Young-Taek Chun Mi-Son Kim Sang-Won Cho O-Yeon Heo Jae-Sung
|
|
Abstract
|
|
|
Purpose: Our institution has implemented two different adjuvant protocols in treating patients with non-small cell lung cancer (NSCLC): chemotherapy followed by concurrent chemoradiotherapy (CT-CCRT) and sequential postoperative radiotherapy (PORT) followed by postoperative chemotherapy (POCT). We aimed to compare the clinical outcomes between the two adjuvant protocols.
Materials and Methods: From March 1997 to October 2012, 68 patients were treated with CT-CCRT (n = 25) and sequential PORT followed by POCT (RT-CT; n = 43). The CT-CCRT protocol consisted of 2 cycles of cisplatin-based POCT followed by PORT concurrently with 2 cycles of POCT. The RT-CT protocol consisted of PORT followed by 4 cycles of cisplatin-based POCT. PORT was administered using conventional fractionation with a dose of 50.4?60 Gy. We compared the outcomes between the two adjuvant protocols and analyzed the clinical factors affecting survivals.
Results: Median follow-up time was 43.9 months (range, 3.2 to 74.0 months), and the 5-year overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 53.9%, 68.2%, and 51.0%, respectively. There were no significant differences in OS (p = 0.074), LRFS (p = 0.094), and DMFS (p = 0.490) between the two protocols. In multivariable analyses, adjuvant protocol remained as a significant prognostic factor for LRFS, favouring CT-CCRT (hazard ratio [HR] = 3.506, p = 0.046) over RT-CT, not for OS (HR = 0.647, p = 0.229).
Conclusion: CT-CCRT protocol increased LRFS more than RT-CT protocol in patients with completely resected NSCLC, but not in OS. Further studies are warranted to evaluate the benefit of CCRT strategy compared with sequential strategy.
|
|
KEYWORD
|
|
Non-small-cell lung carcinoma, Adjuvant chemotherapy, Adjuvant radiotherapy, Sequence of therapies
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|