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J Korean Soc Ther Radiol Oncol > Volume 16(3); 1998 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 1998;16(3): 275-282.
The Results of Hyperfractionated Radiotherapy on Locally Advanced Non-Small Cell Lung Cancer
Won Joo Hur, Hyung Sik Lee, Jeong Ki Kim, Young Min Choi, Ho Jun Lee, Seon Min Youn, Jae seok Kim, Hyo Jin Kim, Jong Soo Woo, Pill Jo Choi, Ki Nam Lee
1Department of Radiation Oncology, Dong-A University, College of Medicine, Pusan, Korea.
2Department of Hemato-oncology Thoracic Surgery, Dong-A University, College of Medicine, Pusan, Korea.
3Department of Diagnostic Radiology, Dong-A University, College of Medicine, Pusan, Korea.
The effect of hyperfractionated radiotherapy on locally advanced non-small lung cancer was studied by a retrospective analysis.
We analyzed sixty one patients of biopsy-confirmed, IIIA and IIIB non-small cell lung cancer. Using the ECOG performance scale, all the patients were scored less than 2. They were treated by curative hyperfractionated radiotherapy alone from Oct. 1992 to Oct. 1995 at the Department of Radiation Oncology. All the patients received 120cGy b.i.d with more than 6 hours interval between each fraction. The total dose of radiation was reached up to 6400-7080 cGy with a mean dose of 6934 cGy. The results were analyzed retrospectively.
The overall survival rate was 53.1% in 1 year, 9.9% in 2 years with a median survival time (MST) of 13.9 months. The progression free survival (PFS) rate was 37.0% in 1 year, 8.9% in 2 years. Twenty two patients were classified as complete responders to this treatment and their MST was 19.5 months. When this was compared with that of partial responders (MST: 11.7months), it was statistically significant (p=0.0003). Twenty nine patients of stage IIIA showed a better overall survival rate (1yr 63.3%, 2yr 16.8%) than IIIB patients (1yr 43.3%, 2yr 3.6%), which was also statistically signifcant (p=0.003). Patients with adenocarcinoma showed a better survival rate (1yr 64.3%, 2yr 21.4%) than that of squamous cell counterpart (1yr 49.4%, 2yr 7.4%), although this was not significant statistically (p=0.61). Two patients developed fatal radiation-induced pneumonia right after the completion of the treatment which progressed rapidly and they all died within 2 months. One patient developed radiation-induced fibrosis after 13 months. He refused further treatment and died soon after the development of fibrosis.
Among locally advanced NSCLC, hyperfractionated radiotherapy was effective on stage IIIA patients by increasing MST with acceptable toxicities. Acute radiation-induced pneumonia should be carefully monitored and must be avoided during or after this treatment.
Key Words: NSCLC, Hyperfractionated radiotherapy
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