Clinical Responses and Prognostic Indicators of Concurrent Chemoradiation for Non-small Cell Lung Cancer
Cancer Research and Treatment 2011³â 43±Ç 1È£ p.32 ~ p.41
À̵¿¼ö(Lee Dong-Soo) - Catholic University School of Medicine Department of Radiation Oncology
±è¿¬½Ç(Kim Yeon-Sil) - Catholic University School of Medicine Department of Radiation Oncology
°ÁøÇü(Kang Jin-Hyoung) - Catholic University School of Medicine Department of Medical Oncology
ÀÌ»ó³²(Lee Sang-Nam) - Catholic University School of Medicine Department of Radiation Oncology
±è¿µ±Õ(Kim Young-Kyoun) - Catholic University School of Medicine Department of Medical Pulmonology
(Ahn Myung-Im) - Catholic University School of Medicine Department of Radiology
ÇÑ´ëÈñ(Han Dae-Hee) - Catholic University School of Medicine Department of Radiology
À¯ÀÌ·É(Yoo Ie-Ryung) - Catholic University School of Medicine Department of Nuclear Medicine
¿Õ¿µÇÊ(Wang Young-Pil) - Catholic University School of Medicine Department of Thoracic Surgery
(Park Jae-Gil) - Catholic University School of Medicine Department of Thoracic Surgery
À±¼¼Ã¶(Yoon Sei-Chul) - Catholic University School of Medicine Department of Radiation Oncology
ÀåÈ«¼®(Jang Hong-Seok) - Catholic University School of Medicine Department of Radiation Oncology
(Choi Byung-Oak) - Catholic University School of Medicine Department of Radiation Oncology
Abstract
Purpose: To evaluate treatment outcomes and prognostic factors in non-small cell lung cancer (NSCLC) patients treated with concurrent chemoradiation.
Materials and Methods: From January 2005 to June 2009, 51 patients were treated with concurrent chemoradiation for 3 different aims: locally advanced stage III, locally recurrent disease, and postoperative gross residual NSCLC. Median age was 63 years. Distribution of stages by the 6th edition of American Joint Committee on Cancer (AJCC) was as follows: IIIA (37.3%), IIIB (56.9%). Chemotherapy was administered every week concurrently with radiation using one of the following regimens: paclitaxel (60 mg/m2), docetaxel+cisplatin (20 mg/m2+20 mg/m2), cisplatin (30 mg/m2). Total radiation dose was 16-66.4 Gy (median, 59.4 Gy).
Results: Median follow-up duration was 40.8 months. The overall response rate was 84.3% with 23 complete responses. The median survival duration for the overall patient group was 17.6 months. The 3-year survival rate was 17.8%. A total of 21 patients had recurrent disease at the following sites: loco-regional sites (23.6%), distant organs (27.5%). In the multivariate analysis of the overall patient group, a clinical tumor response (p=0.002) was the only significant prognostic factor for overall survival (OS). In the multivariate analysis of the definitive chemoradiation arm, the use of consolidation chemotherapy (p=0.022), biologically equivalent dose (BED)10 (p=0.007), and a clinical tumor response (p=0.030) were the significant prognostic factors for OS.The median survival duration of the locally recurrent group and the postoperative gross residual group were 26.4 and 23.9 months, respectively.
Conclusion: Our study demonstrated that clinical tumor response was significantly associated with OS in the overall patient group. Further investigations regarding the optimal radiation dose in the definitive chemoradiation and the optimal treatment scheme in locally recurrent NSCLC would be required.
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Non-small cell lung cancer, Concurrent chemoradiation, Prognostic factor, Recurrent non-small cell lung cancer
KMID :
0939920110430010032
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clinical tumor response was significantly associated with OS