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Definitive Radiotherapy of Non-Small Cell Lung Cancer
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ÀÌÁ¾¿µ(Lee Jong-Young) - ¿¬¼¼´ëÇб³ ¿øÁÖÀÇ°ú´ëÇÐ Ä¡·á¹æ»ç¼±°ú
¹Ú°æ¶õ(Park Kyung-Ran) - ¿¬¼¼´ëÇб³ ¿øÁÖÀÇ°ú´ëÇÐ Ä¡·á¹æ»ç¼±°ú
Abstract
¸ñ Àû: ±ÙÄ¡Àû ¹æ»ç¼±Ä¡·á¸¦ ¹ÞÀº ºñ¼Ò¼¼Æ÷ Æó¾Ï ȯÀÚÀÇ »ýÁ¸À²°ú »ýÁ¸À²¿¡ ¿µÇâÀ» ¹ÌÄ¡´Â ¿¹ÈÄÀÎÀÚ¸¦ ¾Ë¾Æº¸°í, ¹æ»ç¼±Á¶»ç·®À» 6500 cGy ·Î Áõ°¡½ÃÅ°´Â °ÍÀ̱¹¼Ò°üÇØÀ²°ú »ýÁ¸À²¿¡ ¿µÇâÀ» ¹ÌÄ¡´ÂÁö ¿µÇâÀ» ¾Ë¾Æº¸±â À§ÇÏ¿© º» ¿¬±¸¸¦ °èȹÇÏ¿´´Ù.
¹æ ¹ý: Á¶Á÷ÇÐÀûÀ¸·Î Áõ¸íµÈ ºñ¼Ò¼¼Æ÷ Æó¾ÏÀ¸·Î Áø´Ü¹Þ°í, ¿ø°ÝÀüÀÌ´Â ¾øÀ¸³ª ¼ö¼ú ºÒ°¡´ÉÇÑ È¯ÀÚ¸¦ ´ë»óÀ¸·Î ±ÙÄ¡Àû ¹æ»ç¼±Ä¡·á¸¦ ½ÃÇàÇÏ¿´´Ù. A±ºÀº ÇÏ·ç¿¡ 180 cGy¿¡¼ 200 cGy ¾¿ Á¶»çÇÏ¿© 6000 cGyÀÌÇϸ¦ Á¶»çÇÏ¿´°í, B±ºÀº °°Àº ¹æ¹ýÀ¸·Î 6500 cGy ±îÁö Á¶»çÇÏ¿´´Ù.
°á °ú: 98¸í Àüü ȯÀÚÀÇ 1³â, 2³â, 3³â »ýÁ¸¿ïÀº °¢°¢ 54.0%, 26.6%, 16.4%¿´À¸¸ç Á¤Áß¾Ó »ýÁ¸±â°£Àº 13°³¿ùÀ̾ú´Ù. ¿¹ÈÄÀÎÀÚ Áß Åë°èÇÐÀûÀ¸·Î ÀǹÌÀÖ´Â °ÍÀº º´±â¿Í N-º´±â¿´À¸¸ç ¹æ»ç¼±Á¶»ç·®Àº Àǹ̰¡ ¾ø¾ú´Ù. ±¹¼Ò°üÇØÀ²°ú »ýÁ¸À²¿¡ À־µ A±º°ú B±º »çÀÌ¿¡ Â÷ÀÌ´Â ¾ø¾ú´Ù.
°á ·Ð: ºñ¼Ò¼¼Æ÷ Æó¾ÏÀÇ Ä¡·á ¼ºÀûÀ» ¿Ã¸®±â À§Çؼ ´Ü¼øÈ÷ ¹æ»ç¼± Á¶»ç·®Àº 6500 cGy±îÁö ¿Ã¸®´Â °ÍÀº Àǹ̰¡ ¾ø´Ù ÇÏ°Ú°í, ´õ ¸¹Àº ¹æ»ç¼±·®À» Á¶»çÇÒ ¼ö ÀÖµµ·Ï ´ÙºÐÇÒ ¹æ»ç¼±Ä¡·á¸¦ ½ÃÇàÇϰųª ȤÀº µ¿½Ã ÈÇÐ-¹æ»ç¼±¿ä¹ýµî ´Ù¸¥ Ä¡·á¹æ¹ýÀ» °í·ÁÇØ¾ß ÇÒ °ÍÀ¸·Î »ç·áµÈ´Ù.
Purpose: The effect of dose escalation of up to 6500 cGy on local control and survival was investigated in locally advanced non-small cell lung cancer.
Materials and Methods: Ninety eight patients with biopsy-proven unresectable non-small cell lung cancer without distant metastases or medically inoperable patients with lower-stage were treated with definitive radiotherapy alone. Group A were treated by thoracic irradiation, 6000 cGy or less in total tumor dose with daily fractions of 180 to 200 cGy: and group B was treated with 6500 cGy of same daily fractions.
Results: The actuarial overall survival rate for the entire group was 54% at 1 year, 26.6% at 2 years and 16.4% at 3 years with a median survival time of 13 months. Statistically significant prognostic factors that affect survival rate were stage and N-stage. However, no improvement in local control and survival has been seen with higher dose radiotherapy(group B).
Conclusion: Dose escalation of up to 6500 cGy was no effect on local control and survival rate. To increase the survival rate of non-small cell lung cancer hyperfractionated radiotherapy or concurrent chemoradiotherapy should be considered.
Å°¿öµå
Non-small cell lung cancer, Radiotherapy
KMID :
0362919950130040303
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À¯È¿¼º°á°ú(Recomendation)
Dose escalation of up to 6500 cGy was no effect on local control and survival rate. To increase the survival rate of non-small cell lung cancer hyperfractionated radiotherapy or concurrent chemoradiotherapy should be considered.