잠시만 기다려 주세요. 로딩중입니다.

Effect of Radiation Therapy Techniques on Outcome in N3-positive IIIB Non-small Cell Lung Cancer Treated with Concurrent Chemoradiotherapy

Cancer Research and Treatment
2016년 48권 1호 p.106 ~ p.114
노재명 ( Noh Jae-Myoung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology

김진만 ( Kim Jin-Man ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
안용찬 ( Ahn Yong-Chan ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
표홍렬 ( Pyo Hong-Ryull ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
김보경 ( Kim Bo-Kyong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
오동렬 ( Oh Dong-Ryul ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
주상규 ( Ju Sang-Gyu ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
김진성 ( Kim Jin-Sung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
신정석 ( Shin Jung-Suk ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
홍채선 ( Hong Chae-Seon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
박효정 ( Park Hyo-Jung ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology
이온주 ( Lee Eon-Ju ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Radiation Oncology

Abstract

Purpose : This study was conducted to evaluate clinical outcomes following definitive concurrent chemoradiotherapy (CCRT) for patients with N3-positive stage IIIB (N3-IIIB) non-small cell lung cancer (NSCLC), with a focus on radiation therapy (RT) techniques.

Materials and Methods : From May 2010 to November 2012, 77 patients with N3-IIIB NSCLC received definitive CCRT (median, 66 Gy). RT techniques were selected individually based on estimated lung toxicity, with 3-dimensional conformal RT (3D-CRT) and intensity-modulated RT (IMRT) delivered to 48 (62.3%) and 29 (37.7%) patients, respectively. Weekly docetaxel/paclitaxel plus cisplatin (67, 87.0%) was the most common concurrent chemotherapy regimen.

Results : The median age and clinical target volume (CTV) were 60 years and 288.0 cm3, respectively. Patients receiving IMRT had greater disease extent in terms of supraclavicular lymph node (SCN) involvement and CTV ≥ 300 cm3. The median follow-up time was 21.7 months. Fortyfive patients (58.4%) experienced disease progression, most frequently distant metastasis (39, 50.6%). In-field locoregional control, progression-free survival (PFS), and overall survival (OS) rates at 2 years were 87.9%, 38.7%, and 75.2%, respectively. Although locoregional control was similar between RT techniques, patients receiving IMRT had worse PFS and OS, and SCN metastases from the lower lobe primary tumor and CTV ≥ 300 cm3were associated with worse OS. The incidence and severity of toxicities did not differ significantly between RT techniques.

Conclusion : IMRT could lead to similar locoregional control and toxicity, while encompassing a greater disease extent than 3D-CRT. The decision to apply IMRT should be made carefully after considering oncologic outcomes associated with greater disease extent and cost.

키워드

원문 및 링크아웃 정보
 
등재저널 정보
SCI(E) MEDLINE 학술진흥재단(KCI) KoreaMed 대한의학회 회원 
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)
연구비지원
(Fund Source)
근거수준평가
(Evidence Hierarchy)
출판년도
(Year)
참여저자수
(Authors)
대표저자
(1st Authors)
Doi
KCD코드
ICD 03
건강보험코드