Lack of the Difference in Outcome between N2 and N3 Non-Small Cell Lung Cancer Patients Treated with Concurrent Chemoradiotherapy; A Retrospective Analysis of 186 Patients

Kim, Young Seok; Lee, Sang Wook; Choi, Eun Kyung; Kim, Jong Hoon; Ahn, Seung Do; Shin, Seong Soo; Lee, Jung Shin; Suh, Cheolwon; Kim, Sang We; Kim, Dong Soon; Kim, Woo Sung; Lee, Sang Do

Abstract

PURPOSE: To evaluate the difference in the patterns of failure and treatment for the outcomes of concurrent chemoradiotherapy, between clinical stage N2 and N3, in locally advanced unresectable stage III non-small cell lung cancer (NSCLC).
MATERIALS AND METHODS
Between 1993 and 2000, 186 patients with gross mediastinal node positive non-small cell lung cancer, received concurrent chemoradiation therapy. The median follow-up period was 13 months, ranging from 1 to 65 months. The patterns of failure and treatment of outcomes of N2 and N3 were retrospectively analyzed.
RESULTS
There were 170 men and 16 women, with an approximate man : woman ratio of 10 : 1. The median age of the patients was 60 years, ranging from 37 to 76 years. The numbers of patients with N2 and N3 stages were 90 and 96, respectively. Supraclavicular node metastasis was seen in 39 patients. Progression free survival rates of the N2 and N3 stages were 58% and 45%, respectively. The overall survival rates of the N2 and N3 stages were 34% and 27%, respectively. There were no statistically significant differences in progression free and overall survival rates between the two groups. There were statistically significant differences in the overall and progression free survival rates in relation to the supraclavicular lymph node positivity. Locoregional failure within radiation fields was the major pattern of failure.
CONCLUSION
There were no differences in the patterns of failure and treatment outcomes with concurrent chemoradiation treatment. However, in this study, patients with supraclavicular node metastasis were considered to have an incurable disease. Therefore, a further investigation of the treatment scheme will be required in these cases.