ABSTRACT
The benefit achieved by concurrent chemoradiotherapy (CCR) and sequential chemoradiotherapy (SCR) vs radiotherapy (RT) alone for patients with stage Ⅱ-Ⅳa nasopharyngeal carcinoma (NPC) was compared.A total of 113 patients with stage Ⅱ-Ⅳa NPC were allotted into CCR group (n=38),SCR group (n=36) and RT alone group (n=39).All patients were irradiated with the same RT technique to ≥66 Gy at 2 Gy per fraction,conventional 5 fractions/week in all groups.The CCR group received concurrent chemotherapy of weekly cisplatin for 7 weeks,and the SCR group received neoadjuvant and (or) adjuvant chemotherapy.The results showed that the 3- and 5-year overall survival rate was significantly higher in CCR group than in RT alone group (92.16％ vs 61.54％,81.58％ vs 51.28％,P＜0.005).The median survival time was significantly longer in CCR group than in RT alone group (67.8 months vs 52.7 months,P＜0.005).It was concluded that CCR could significantly improve overall survival rate,progression-free survival rate,and median survival time when compared with RT alone.
ABSTRACT
Purpose:To evaluate the efficacy and toxic and side effects of brain metastases of lung cancer treated with chemotherapy and conventional radiotherapy. Methods:45 cases of brain metastases of lung cancer were treated with sequential chemotherapy of VM26DDP regimens and conventional radiotherapy. The complete remission and partial remission rate ,1-,2-,3-year survival rate and toxic and side effects were observed.Results:The complete remission and partial remission rate of salitary as well as multiple brain metastases of non-small-cell lung cancer and small-cell lung cancer were (92.86%) and 80.94%,75% and 83.33%, respectively . The 1-,2-,3-year survival rate of salitary and multiple brain metastases of non-small-cell lung cancer was 13.33% and 14.29%、9.5% and 4.76%、9.5% and 0. The 1-,2-,3-year survival rate of salitary and multiple brain metastases of small-cell lung cancer were 50% and 50%、25% and 33.33%、25% and 16.67%, respectively. The Ⅰ,Ⅱ,Ⅲ and Ⅳ degree myelosuppression was 33.33%,28.89%,17.78%,8.89%, respectively.Conclusions:The efficacy of brain metastases of lung cancer treated with sequential chemotherapy by VM26+DDP regimens and conventional radiotherapy is better and with less toxic and side effects.
ABSTRACT
Background: Combination chemotherapy is now considered to be the cornerstone of small cell lung cancer (SCLC). management but the optimal management of limited SCLC is not well defined. The role of thoracic radiotherapy (TRT) is less well established. Recent meta-analyses reports revealed that TRT combined with chemotherapy produce "good" local control and prolonged survival. But other reports that survival was not changed. The timing, dose, volume and fractionation for TRT with the combined chemotherapy of SCLC remains unsettled. In this study, we analyzed the effects according to the timing of thoracic radiotherapy in limited SCLC. Method: All fifty one patients received cytoxan, adriamycin and vincristine(CAV) alternating with etoposide and cisplatin(VPP) every 3 weeks for 6 cycles were randomized prospectively into two groups: concurrent and sequential. 27 patients received 4500cGy in 30 fractions(twice daily 150cGy fractional dose) over 3 weeks to the primary site concurrent with the first cycle of VPP(concurrent gorup). 24 patients received 4000 to 5000cGy over 5 or 6 weeks after completion of sixth cycles of chemotherapy(sequential group). Results: 1. Response rates and response duration: Response rates were not significantly different between two groups(p=0.13). But response duration was superior in the concurrent group(p=0.03). 2. Survival duration was not different between two groups(p=0.33). 3. Local control rate was superior in the concurrent group(p=0.00). 4. Side effects and toxicities: Hematologic toxicides, especially leukopenia, infection and frequency of radiation esophagitis were higher in the concurrent group(p=0.00, 0.03, 0.03). Conclusion: The concurrent use of TRT with chemotherapy failed to improve the survival of limited stage SCLC patients compared with the sequential use of TRT but response duration and local control rate were superior in the concurrent group. Frequency of radiation esophagitis, life threatening hematologic toxicities and infection were more frequent in the concurrent group than sequential group. So, the selection of an optimal schedule of chemotherapy combined with TRT that would lead to a major increase in survival with minimal toxicity is remained to be validated in large scale study in the future.