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J Korean Soc Ther Radiol Oncol > Volume 24(4); 2006 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2006;24(4): 230-236.
Treatment Outcome of Locally Advanced Non-small Cell Lung Cancer Patients Who Received Concurrent Chemoradiotherapy with Weekly Paclitaxel
Suzy Kim, Sung Whan Kim, Byoung Yong Shim, Chi Hong Kim, So Hyang Song, Meyung Im Ahn, Deog Gon Cho, Kyu Do Cho, Jinyoung Yoo, Hoon Kyo Kim
1Lung Cancer Center, St. Vincent's Hospital, Department of Radiation Oncology, The Catholic University of Korea College of Medicine, Korea. kimandre@catholic.ac.kr
2Department of Internal Medicine, The Catholic University of Korea College of Medicine, Korea.
3Department of Diagnostic Radiology, The Catholic University of Korea College of Medicine, Korea.
4Department of Chest Surgery, The Catholic University of Korea College of Medicine, Korea.
5Department of Pathology, The Catholic University of Korea College of Medicine, Korea.
To analyze the response, toxicity, patterns of failure and survival rate of patients with locally advanced non-small cell lung cancer who were treated with concurrent chemoradiotherapy with weekly paclitaxel.
Twenty-three patients with locally advanced non-small cell lung cancer patients who received radical chemoradiotherapy from October 1999 to September 2004 were included in this retrospective study. Patients received total 55.4~64.8 (median 64.8) Gy (daily 1.8 Gy per fraction, 5 days per weeks) over 7~8 weeks. 50 or 60 mg/m2 of paclitaxel was administered on day 1, 8, 15, 22, 29 and 36 of radiotherapy. Four weeks after the concurrent chemoradiotherapy, three cycles of consolidation chemotherapy consisted of paclitaxel 135 mg/m2 and cisplatin 75 mg/m2 was administered every 3 weeks.
Of the 23 patients, 3 patients refused to receive the treatment during the concurrent chemoradiotherapy. One patient died of bacterial pneumonia during the concurrent chemoradiotherapy. Grade 2 radiation esophagitis was observed in 4 patients (17%). Sixteen patients received consolidation chemotherapy. During the consolidation chemotherapy, 8 patients (50%) experienced grade 3 or 4 neutropenia and one of those patients died of neutropenic sepsis. Overall response rate for 20 evaluable patients was 90% including 4 complete responses (20%) and 14 partial responses (70%). Among 18 responders, 9 had local failure, 3 had local and distant failure and 2 had distant failure only. Median progression-free survival time was 9.5 months and 2-year progression-free survival rate was 19%. Eleven patients received second-line or third-line chemotherapy after the treatment failure. The median overall survival time was 21 months. 2-year and 5-year survival rate were 43% and 33%, respectively. Age, performance status, tumor size were significant prognostic factors for progression-free survival.
Concurrent chemoradiotherapy with weekly paclitaxel revealed high response rate and low toxicity rate. But local failure occurred frequently after the remission and large tumor size was a poor prognostic factor. Further investigations are needed to improve the local control.
Key Words: Non-small cell lung cancer, Concurrent Chemoradiotherapy, Paclitaxel
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