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Hyperfractionated Radiotherapy with Concomitant Boost Technique for Unresectable Non-Small Cell Carcinoma of the Lung

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ÀüÇÏÁ¤(Chun Ha-Chung) - ÇѾç´ëÇб³ ÀÇ°ú´ëÇÐ Ä¡·á¹æ»ç¼±°úÇб³½Ç
À̸íÀÚ(Lee Myung-Za) - ÇѾç´ëÇб³ ÀÇ°ú´ëÇÐ Ä¡·á¹æ»ç¼±°úÇб³½Ç

Abstract

25¿¹ÀÇ ÀýÁ¦ ºÒ°¡´ÉÇÑ ºñ¼Ò¼¼Æ÷Æä¾Ï ȯÀÚ¸¦ ´ÙºÒÇÒÁ¶»ç ¹æ»ç¼± Ä¡·á ¹× Ãß°¡ Á¶»ç ±â¼ú·Î Ä¡·áÇÏ¿´´Ù. Àü¿¡ ¼ö¼úÀ̳ª Ç×¾ÏÁ¦ Ä¡·á¸¦ ¹Þ¾Ò°Å³ª ´Á¸·»ïÃâ ¹× ½ÉÇÑ Ã¼Áß °¨¼Ò (üÁßÀÇ 10%ÀÌ»ó)°¡ Àִ ȯÀÚ´Â ÀÌ ¿¬±¸¿¡¼­ Á¦¿ÜÇß´Ù. óÀ½ 3ÁÖ¿¡ °ÉÃÄ 27Gy¸¦ 15¹ø¿¡ ³ª´©¾î large field¿¡ Á¶»çÇÏ¿´´Ù. ±× ÈÄ¿¡ large field¿¡ 18È¿¸¦ ÁØ ÈÄ cone down boost field¿¡ 14 Gy¸¦ ÁÖ¾ú´Ù. ÃÑ Á¶»ç·®Àº 12¸íÀÇ È¯ÀÚ¿¡¼­´Â 62.2Gy, 13¸íÀÇ È¯ÀÚ¿¡¼­´Â 65.4Gy¿´´Ù. ÃßÀû°üÂû ±â°£Àº 6°³¿ù¿¡¼­ 24°³¿ù »çÀÌ¿´´Ù. ½ÇÁúÀûÀÎ »ýÁ¸À²Àº 6,12,18°³¿ù¿¡ °¢°¢ 88%, 62%, 38%¿´´Ù. ¹«º´ »ýÁ¸À²Àº 88%, 41%, 21%¿´´Ù. ÁýÇÕÀû ±¹¼Ò Àç¹ßÀ²Àº 9, 12, 15°³¿ù¿¡ °¢°¢ 36%, 43%, 59%À̾ú´Ù. 24°³¿ù°£ ÃßÀû°üÂûÇÑ °á°ú ±Þ¼º ÇÕº´ÁõÀ̳ª Èıâ ÇÕº´ÁõÀÇ Áõ°¡´Â ¾ø¾ú´Ù. ´õ ±ä ±â°£ÀÇ ÃßÀû°üÂûÀÌ ÇÊ¿äÇÏÁö¸¸, ÀýÁ¦ ºÒ°¡´ÉÇÑ ºñ¼Ò¼¼Æ÷ Æó¾ÏÀÇ ´ÙºÐÇÒÁ¶»ç ¹æ»ç¼± Ä¡·á ¹× Ãß°¡ Á¶»ç±â¼úÀÇ È¿°ú¸¦ ÆÇÁ¤Çϴµ¥´Â ¹«ÀÛÀ§ ÃßÃâ¹ýÀ» »ç¿ëÇÏ¿© prospective ¿¬±¸¸¦ ½ÃÇàÇÔÀÌ ÇÊ¿äÇϸ®¶ó »ý°¢µÈ´Ù.
Twenty five patients with unresectable non-small cell carcinoma of the lung have been treated with hyperfractionated radiotherapy with concomitant boost technique since September, 1989.
Those patients with history of previous surgery or chemotherapy, pleural effusion or significant weight loss (greater than 10% of body weight) were excluded from the study. Initially, 27 Gy were delivered in 15 fractions in 3 weeks to the large field. Thereafter, large field received 1.8 Gy and cone downboost field received 1.4Gy with twice a day fractinations up to 49.4Gy.
After 49.4Gy, only boost field was treated twice a day with 1.8 and 1.4 Gy. Total tumor doses were 62.2Gy for 12 patients and 65.4Gy for remaining 13 patients. Follow up period was ranged from 6 to 24 month. Actuarial survival rates at 6, 12, and 18 month were 88%, 62%, and 38%, respectively. Corresponding disease free survival rates were 88%, 41%, and 21%, respectively.
Actuarial cumulative local failure rates at 9,12 and 15 month were 36%, 42%, and 59%, respectively. No significant increase of acute or late complications including radiation pneumonitis was noted with maximum follow up of 24 month. Although the longer follow up is needed, it is worthwhile to try the prospective randomized study to evaluate the efficacy of hyperfractionated radiotherapy with concomitant boost technique for unresectable non-small cell lung cancers in view of excellent tolerance of this treatment. In the future, further increase of total radiation dose might be necessary to improve local control for non-small cell lung cancer.

Å°¿öµå

Hyperfractionation, Radiotherapy, Non-small cell lung cancer
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Survival rates at 6, 12, and 18 month were 88%, 62%, and 38%, respectively. Corresponding disease free survival rates were 88%, 41%, and 21%, respectively.
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DOI
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ICD 03
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