| Hyperfractionated Radiotherapy and Concurrent Chemotherapy for Stage III Unreasectabel Non Small Cell Lung Cancer: Preliminary Report for Response and Toxicity |
| Eun Kyung Choi, Jong Hoon Kim, Hyesook Chang, Sang We Kim, Cheolwon Suh, Kyoo Hyung Lee, Jung Shin Lee, Sang Hee Kim, Youn Suk Ko, Woo Sung Kim, Dong Soon Kim, Won Dong Kim, Koun Sik Song, Seung Il Park, Kwang Hyun Sohn |
1Department of Radiation Oncology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
2Department of Internal Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
3Department of Diagnositc Radiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
4Department of Cardiovascular and Thoracic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea. |
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| ABSTRACT |
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Lung cancer study group at Asan Medical Center has conducted the second prospective study to determine the efficacy and feasibility of MVP chemotherapy with concurrent hyperfractionated radiotherapy for patients with stage III unresectable non-small cell lung cancer(NSCLC). All eligible patients with stage III unresectable NSCLC were treated with hyperfractionated radiotherapy( 120 cGy/fx BID, 6480 cGY/54fx) and concurrent 2 cycles of MVP(Motomycin C 6 mg/m2 , d2 & d29, Vinblastin 6 mg/m2, d2 & d29, Cisplatin 6 mg/m2 , d1 & d28) chemotherapy. Between Aug. 1993 and Nov. 1994, 62 patients entered this study ; 6(10%) had advanced stage IIIa and 56(90%) had IIIb disease including 1 with pleural effusion and 10 with supraclavicular metastases. Among 62 Ptients, 48(77%) completed planned therapy. Fourteen patients refused further treatment during chemoradiotherapy.
Of 46 patients evaluable for response, 34(74%) showed major response including 10(22%) with complete and 24(52%) with partial responses. Of 48 patients evaluable for toxicity, 13(27%) showed grade IV hematologic toxicity but treatment delay did not exceed 5 days. Two patients died of sepsis during chemoradiotherapy. Server weight(more than 10%) occurred in 9 patients(19%) during treatment. Nine patients(19%) developed radiation pneumonitis. Six of these patients had grad I(mild) pneumonitis with radiographic changes within the treatment fields. Three other patients had grade II pneumonitis, but none of theses patients had continuous symptoms after steroid treatment. Concurrent chemoradiotherapy for patients with advanced NSCLC was well tolerated with acceptable toxicity and achieved higher response rates than the first study, but rather low compliance rate(7%) in this study is worrisome. We need to improve nutritional suppoert during treatment and to use G-CSF to improve leukopenia and if necessary, supportive care will given as in patients. Longer follow-up and larger sample size is needed to observe survival advantage. |
| Key Words:
Non-Small Cell Lung Cancer, Concurrent Chemoradiotherapy |
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