Accelerated high-dose radiotherapy alone or combined with either concomitant or sequential chemotherapy; treatments of choice in patients with Non-Small Cell Lung Cancer
| Autor: | Bradley R. Pieters, Apollonia L. J. Uitterhoeve, Caro C.E. Koning, Kees Koedooder, Rob M. van Os, Mia G. J. Koolen, Marlou van de Kar |
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| Přispěvatelé: | Radiotherapy, Pulmonology, Cancer Center Amsterdam |
| Rok vydání: | 2007 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
Oncology Male medicine.medical_specialty Lung Neoplasms Time Factors lcsh:R895-920 medicine.medical_treatment Urology Short Report Antineoplastic Agents lcsh:RC254-282 Recurrence Internal medicine Carcinoma Non-Small-Cell Lung Medicine Combined Modality Therapy Humans Radiology Nuclear Medicine and imaging Lung cancer Radiometry Aged Cisplatin Chemotherapy business.industry Incidence (epidemiology) Middle Aged lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease Radiation therapy Treatment Outcome Concomitant Multivariate Analysis Female business Complication medicine.drug |
| Zdroj: | Radiation Oncology (London, England) Radiation oncology (London, England), 2. BioMed Central Radiation Oncology, Vol 2, Iss 1, p 27 (2007) |
| ISSN: | 1748-717X |
| Popis: | Background Results of high-dose chemo-radiotherapy (CRT), using the treatment schedules of EORTC study 08972/22973 or radiotherapy (RT) alone were analyzed among all patients (pts) with Non Small Cell Lung Cancer (NSCLC) treated with curative intent in our department from 1995–2004. Material Included are 131 pts with medically inoperable or with irresectable NSCLC (TNM stage I:15 pts, IIB:15 pts, IIIA:57 pts, IIIB:43 pts, X:1 pt). Treatment Group I: Concomitant CRT: 66 Gy/2.75 Gy/24 fractions (fx)/33 days combined with daily administration of cisplatin 6 mg/m2: 56 pts (standard). Group II: Sequential CRT: two courses of a 21-day schedule of chemotherapy (gemcitabin 1250 mg/m2 d1, cisplatin 75 mg/m2 d2) followed by 66 Gy/2.75 Gy/24 fx/33 days without daily cisplatin: 26 pts. Group III: RT: 66 Gy/2.75 Gy/24 fx/33 days or 60 Gy/3 Gy/20 fx/26 days: 49 pts. Results The 1, 2, and 5 year actuarial overall survival (OS) were 46%, 24%, and 15%, respectively. At multivariate analysis the only factor with a significantly positive influence on OS was treatment with chemo-radiation (P = 0.024) (1-, 2-, and 5-yr OS 56%, 30% and 22% respectively). The incidence of local recurrence was 36%, the incidence of distant metastases 46%. Late complications grade 3 were seen in 21 pts and grade 4 in 4 patients. One patient had a lethal complication (oesophageal). For 32 patients insufficient data were available to assess late complications. Conclusion In this study we were able to reproduce the results of EORTC trial 08972/22973 in a non-selected patient population outside of the setting of a randomised trial. Radiotherapy (66 Gy/24 fx/33 days) combined with either concomitant daily low dose cisplatin or with two neo-adjuvant courses of gemcitabin and cisplatin are effective treatments for patients with locally advanced Non-Small Cell Lung Cancer. The concomitant schedule is also suitable for elderly people with co-morbidity. |
| Databáze: | OpenAIRE |
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