Radiotherapy for Locoregional Recurrent Non-Small Cell Lung Cancer

Journal of Lung Cancer 2011년 10권 1호 p.37 ~ p.43

김미영(Kim Mi-Young) - Seoul National University College of Medicine Department of Radiation Oncology
김재성(Kim Jae-Sung) - Seoul National University College of Medicine Department of Radiation Oncology
이종석(Lee Jong-Seok) - Seoul National University College of Medicine Department of Internal Medicine

Abstract

Purpose:To retrospectively evaluate the outcomes and complications of curative radiotherapy for locoregionally recurrent non-small cell lung cancer (NSCLC).

Materials and Methods : From 2004 to 2008, 21 patients received curative radiotherapy for locoregionally recurrent NSCLC without systemic metastasis after surgery. At the time of recurrence, the median age was 70 years (range 49∼81 years), and 19 patients were male. Most patients (n=17) were ECOG 0 or 1 performance status. The median disease-free interval was 15 months. Distribution of recurrence sites were mediastinal lymph nodes (n=10), ipsilateral hilar lymph nodes (n=4), ipsilateral lung parenchyma (n=4), bronchial stump (n=2) and ipsilateral supraclavicular lymph nodes (n=1). Radiotherapy was administered (median 66 Gy, range 59.4∼70 Gy) by a three-dimensional conformal technique. Thirteen patients received chemotherapy concurrently during radiotherapy. Pulmonary function test (PFT) was also used to detect lung function change before and after radiation.

Results:The median survival and 1- and 2-year survival rates were 17 months, 68% and 34%, respectively. Concurrent chemotherapy did not affect post- recurrence overall survival (p=0.183). Seven patients (33% of all patients) had re-progression within the radiation field at a median time of 4 months after completion of radiation. Diffusing lung capacity for carbon monoxide of lung after radiotherapy decreased significantly compared with pre-radiotherapy status (p=0.033). Radiation pneumonitis of any grade was seen in 11 patients. Three patients died of pulmonary complications: one of bacterial pneumonia, one of exacerbation of underlying interstitial pulmonary fibrosis and one of radiation pneumonitis.

Conclusion:This retrospective study showed that curative radiotherapy for locoregionally recurrent NSCLC resulted in a median survival of 17 months and a 2-year survival rate of 34%, which is comparable to other studies. Patients suitable for curative radiotherapy for recurrent NSCLC could be treated aggressively, such as using high dose radiation with or without chemotherapy. However, pre-radiotherapy lung function should be carefully evaluated to avoid serious post-treatment lung damage considering poor lung function of post-resection patients.

키워드

Non-small cell lung carcinoma, Local recurrence, Radiotherapy
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 median survival and 1- and 2-year survival rates were 17 months, 68% and 34%, respectively.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
KCD코드
ICD 03
건강보험코드