J Korean Soc Ther Radiol Oncol.
2006 Dec;24(4):230-236.
Treatment Outcome of Locally Advanced Non-small Cell Lung Cancer Patients Who Received Concurrent Chemoradiotherapy with Weekly Paclitaxel
- Affiliations
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- 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.
Abstract
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PURPOSE: 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.
MATERIALS AND METHODS
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.
RESULTS
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.
CONCLUSION
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.
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