KCTBASE

Postoperative Adjuvant Chemotherapy and Radiotherapy for Stage II and III Non-Small Cell Lung Cancer (NSCLC)

Journal of Lung Cancer 2002년 1권 1호 p.34 ~ p.40

박진홍(Park Jin-Hong) - 울산대학교 의과대학 서울아산병원 방사선종양학과
이상욱(Lee Sang-Wook) - 울산대학교 의과대학 서울아산병원 방사선종양학과
최은경(Choi Eun-Kyung) - 울산대학교 의과대학 서울아산병원 방사선종양학과
정원규(Chung Weon-Kuu) - 울산대학교 의과대학 서울아산병원 방사선종양학과
신경환(Shin Kyung-Hwan) - 울산대학교 의과대학 서울아산병원 방사선종양학과
안승도(Ahn Seung-Do) - 울산대학교 의과대학 서울아산병원 방사선종양학과
김종훈(Kim Jong-Hoon) - 울산대학교 의과대학 서울아산병원 방사선종양학과
김상위(Kim Sang-We) - 울산대학교 의과대학 서울아산병원 내과학교실
서철원(Suh Chul-Won) - 울산대학교 의과대학 서울아산병원 내과학교실
이정신(Lee Jung-Shin) - 울산대학교 의과대학 서울아산병원 내과학교실
김우성(Kim Woo-Sung) - 울산대학교 의과대학 서울아산병원 호흡기내과
김동순(Kim Dong-Soon) - 울산대학교 의과대학 서울아산병원 호흡기내과
김동관(Kim Dong-Kwan) - 울산대학교 의과대학 서울아산병원 흉부외과
박승일(Park Seung-Il) - 울산대학교 의과대학 서울아산병원 흉부외과
손광현(Sohn Kwang-Hyun) - 울산대학교 의과대학 서울아산병원 흉부외과

Abstract

Purpose: The role of postoperative adjuvant chemo-radiotherapy in the treatment of patients with non-small cell lung cancer (NSCLC) remains unclear. This study was undertaken to evaluate the survival outcomes, relapse patterns, prognostic factors and complications of postoperative adjuvant MVP chemotherapy and radiotherapy.

Materials and Methods: The study involved some 96 patients who had undergone curative resection of stage II and III NSCLC between 1991 and 1996. Among these, 94 patients who completed their adjuvant treatment were analyzed. Surgery consisted of pneumonectomy (33%), single lobectomy (54%) or bilobectomy (13%). Within 4 weeks of curative resection, two cycles of MVP chemotherapy (mitomycin C 8 mg/m2, vinblastine 8 mg/m2, cisplatin 60 mg/m2) were started at 4 weeks intervals. Conventionally fractionated radiotherapy was given 3 weeks after chemotherapy to a total dose of 50 Gy in completely resected patients and 55∼60 Gy in patients with positive resection margins.

Results: The TNM classification of the AJCC, as revised in 1997, was used for pathologic staging. The number of patients at AJCC stages IIa, IIb, IIIa, and IIIb were 4, 40, 45, and 5, respectively. A pathologically positive bronchial resection margin was found in nine patients. At the time of analysis, death was recorded in 29 patients (31%), though five had died without evidence of lung cancer. Overall 2-year, 3-year, and 5-year survival rates for all patients were 74.2%, 70.2%, and 65%, respectively, locoregional disease- free survival (LRDFS) rates were 88.6%, 83.7%, 74.3%, at 2-years, 3-years, and 5-years, and distant metastasis disease-free survival (DMDFS) rates were 67.7%, 65.0%, and 63.6%, respectively. In the multivariate model, a primary tumor size of more than 5 cm and the level of pathologically positive nodes were found to be associated with poor overall survival, LRDFS and DMDFS. Although positive bronchial resection margin affected overall survival, LRDFS and DMDFS were unaffected. With respect to the first site of relapse, distant metastasis occurred more frequently (N=33, 35%) than locoregional recurrence (N=15, 16%). Grade 3 esophagitis in two patients and weight loss of more than 10% in five patients were observed during adjuvant treatment. Grade 4 pulmonary toxicity was observed in one patient after radiotherapy and this patient ultimately died 5 months after treatment.
Conclusion: The postoperative adjuvant MVP chemotherapy and radiotherapy regimen showed relatively low locoregional recurrence and distant metastasis rates and good survival rate with acceptable toxicity. A prospective randomized trial, which compares this regimen to surgery alone or postoperative adjuvant radiotherapy is needed.

키워드

Non-small cell lung cancer, Surgical treatment, Radiation treatment, Chemotherapy

KMID : 0982820020010010034

원문 및 링크아웃 정보

등재저널 정보

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)

The postoperative adjuvant MVP chemotherapy and radiotherapy regimen showed low locoregional recurrence and distant metastasis rates and good survival rate with acceptable toxicity.

연구비지원(Fund Source)

근거수준평가(Evidence Hierarchy)

출판년도(Year)

참여저자수(Authors)

대표저자

DOI

KCD코드

ICD 03

건강보험코드