Cancer Res Treat.  2005 Oct;37(5):273-278.

Treatment Outcomes of Three-Dimensional Conformal Radiotherapy for Stage III Non-Small Cell Lung Cancer

Affiliations
  • 1Department of Radiation Oncology, Chungnam National University, Daejeon, Korea. mjcho@cnu.ac.kr
  • 2Department of Internal Medicine, Chungnam National University, Daejeon, Korea.
  • 3Department of Chest Surgery, Chungnam National University, Daejeon, Korea.
  • 4Department of Cancer Research Institute, Chungnam National University, Daejeon, Korea.

Abstract

PURPOSE
To evaluate the treatment outcomes of the three-dimensional conformal radiotherapy (3D-CRT), in conjunction with induction chemotherapy, for the treatment of stage III non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: Between November 1998 and March 2003, 22 patients with histologically proven, clinical stage III NSCLC, treated with induction chemotherapy, followed by 3D-CRT, were retrospectively analyzed. There were 21 males (96%) and 1 female (4%), with a median age of 68.5 (range, 42~79). The clinical cancer stages were IIIA and IIIB in 41 and 59%, respectively. The histologies were squamous cell carcinoma, adenocarcinoma and others in 73, 18 and 9%, respectively. Twenty patients (91%) received induction chemotherapy before radiation therapy. The majority of the chemotherapy regimen consisted of cisplatin and gemcitabine. Radiation was delivered with conventional anteroposterior/ posteroanterior fields for 36 Gy, and then 3D-CRT was performed. The total radiation dose was 70.2 Gy. The median follow-up period was 17 months (range, 4~59 months). RESULTS: The median overall survival was 19 months. The two and four-year overall survival rates were 37.9 and 30.3%, respectively. The median progression-free survival was 21 months. The two and four-year progression-free survival rates were 42.1 and 21%, respectively. The prognostic factors for overall survival by a univariate analysis were age, histology and T stage (p<0.05). Acute radiation toxicities, as evaluated by the RTOG toxicity criteria, included two cases of grade 3 lung toxicity and one case of grade 2 esophagus toxicity. CONCLUSIONS: The radiation dose could be increased without a significant increment in the acute toxicities when using 3D-CRT. It also seems to be a safe, well- tolerated and effective treatment modality for stage III NSCLC.

Keyword

Non-small cell lung carcinoma; Conformal radiotherapy; Chemoradiotherapy

MeSH Terms

Adenocarcinoma
Carcinoma, Non-Small-Cell Lung*
Carcinoma, Squamous Cell
Chemoradiotherapy
Cisplatin
Disease-Free Survival
Drug Therapy
Esophagus
Female
Follow-Up Studies
Humans
Induction Chemotherapy
Lung
Male
Radiotherapy, Conformal*
Retrospective Studies
Survival Rate
Cisplatin

Figure

  • Fig. 1 Overall survival. The median overall survival was 19 months. The two and four-year overall survival rates were 37.9 and 30.3%, respectively.

  • Fig. 2 Progression-free survival. The median progression-free survival was 21 months. The two and four-year progression-free survival rates were 42.1 and 21%, respectively.


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