The Results of Radiation Therapy in Locally Advanced Non-Small Cell Lung Cancer / 대한치료방사선과학회지

ABSTRACT

PURPOSE: This study was done to evaluate the survival rate and prognostic factors of patients with inoperable non-small cell lung cancer (NSCLC) treated with radiation therapy. MATERIALS AND METHODS: A retrospective analysis was undertaken of 62 patients who had inoperable NSCLC treated with radiation therapy from January 1991 through December 1993. According to AJCC staging, stage III A was 14 patients and stage IIIB was 48 patients. Forty Gy to 70.2Gy to the primary tumor site was delivered with daily fractions of 1.8Gy or 2Gy, 5 days per week. Thirty-seven patients received neoadjuvant chemotherapy. RESULTS: Complete, partial and no response to radiation therapy were 3 patients, 34 patients and 25 patients, respectively. The median survival period of all patients was 11 month. One year survival rate, 2 year survival rate and 5 year survival rate for all patients were 45.0%, 14.3%, and 6.0% respectively. The median survival period was 6.5 months in stage IIIA and 13 months in stage IIIB. One year survival rates were 28.6% in stage IIIA and 50.3% in stage IIIB. In univariaite analysis, prognostic factors affecting survival were T-staging, AJCC staging, and response after radiation therapy (P<0.05). Pretreatment peformance status affected survival but was not statistically significant (0.05Survival was not affected by age, sex, pathologic finding, N staging, supraclavicular lymph node status, and neoadjuvant chemotherapy (P<0.1). In multivariate analysis, pathology and response to radiation therapy are independently significant prognostic factor. T stage was marginally significant (P=0.0809). During follow-up duration, distant metastasis developed in 20 patients-bone metastasis in 10 patients, brain metastasis in 3 patients, liver mentastasis in 3 patients, contralateral lung metastasis in 1 patients and multiple metastases in 3 patients.

CONCLUSION:

Conventional radiotherapy alone or combined chemoradiotherapy are unlikely to achieve long term survival in patients with NSCLC. Surgery after concurrent chemoradiotherapy is tried to improve the local control in our hospital.