국소진행된 비소세포 폐암의 선행화학요법후 방사선 병용요법
Effects of Sequential Neoadjuvant Chemotherapy and Radiotherapy in Locally Advanced Non Small Cell Lung Cancer

이화의대지 1994년 17권 4호 p.329 ~ p.336

이순남(Lee Soon-Nam) - 이화여자대학교 의과대학 내과학교실

Abstract

To evaluate the long term results of sequential neoadjuvant chemotherapy followed by radiotherapy in locally advanced non small ciell lung cancer(NSCLC), 32 patients with stage III NSCLC were studied.

Neoadjuvanjt chemotherapy was performed with 2-3 cycles of cisplatin containing combination at the interval of 3-4 weeks, and then radiotherapy to and primary tumor, mediastinum and both supaclavicular lymph nodes was followed.

The results were as follows:

1) After neoadjuvant chemotherapy, partial remission(PR) rate was 59.4% without complete remission(CR). At completion of radiotherapy, CR rate was 28.1%, PR rate 50.0% and overall response rate was 78.1%.

2) The median survival of all patients was 14.4 months, for stage III A NSCLC patients was 22 months compared to 11.4 month in stage III B NSCLC patients without significance. For responder of neoadjuvant chemotherapy, median survival was 16.6 months, and 9.3 months for the non responder(p<0,05). Median survival of responders at completion of chemotherapy was 26.8 months at the rangd of 4-48 months. Overall survival rate at 2 year was 27.1% and continued plateau till 50 months without late relapse.

3) The acute toxicities were tolerable in all patients and not fatal, but late complications of three restricitive pneumonitis and one cough induced syncopal attack compromise the quality of life among the 8 long term survivors who lived over 2 years.

4) The relapse rate was 58.1%(18 out of 31 cases) and the pattern of relapse was local in 14 cases(45.2%), systemic in 3 cases(9.7%) and local plus systemic in 1 case(3.2%). The sites of systemic relapse were brain in 3 cases and brain combined with bone in 1 case.

In conclusion, sequential neoadjuvant chemotherapy and radiotherapy can prolong the survival and diminish the systemic relapse in locally advanced non small cell lung cancer patients but local failure was the main problem in these patients.

To enhance the local control, other trials such as concurrent chemoradiotherapy, hyperfractionated radiotherapy combined with developing more effective new chemotherapeutic agents and combined regimens should be further investigated.

키워드

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주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
Sequential neoadjuvant chemotherapy and radiotherapy can prolong the survival and diminish the systemic relapse in locally advanced non small cell lung cancer patients.
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근거수준평가(Evidence Hierarchy)
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DOI
KCD코드
ICD 03
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