Neoplasma Vol.53, p.30-36, 2006
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Title: The addition of induction chemotherapy with etoposide, ifosfamide, and cisplatin failed to improve therapeutic outcome of concurrent chemoradiotherapy in patients with locally advanced non-small cell lung cancer – single institution retrospective analysis |
Author: H.-W., LEE
; J.-H., CHOI
; H.-Y., LIM
; J.S., PARK
; H.C., KIM
; S., KANG
; Y.T., OH
; M., CHUN
; S.S., SHEEN
; Y.J., OH
; K.J., PARK
; S. C., HWANG
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Abstract: Although chemoradiotherapy (CRT) is a standard treatment for
unresectable locally advanced non-small cell lung cancer
(NSCLC), the optimal sequencing remains to be determined.
We retrospectively compared the treatment results of induction
chemotherapy followed by concurrent CRT (induction
group, 32 patients) with those of concurrent CRT alone (concurrent
group, 41 patients) in unresectable stage IIIA/IIIB
NSCLC patients. In induction group, 2 cycles of induction
chemotherapy (etoposide/ifosfamide/cisplatin: 24 patients, others:
8 patients) were followed by concurrent CRT (60 Gy/30 fractions, 6
mg/m2 of cisplatin daily), while the same concurrent
CRT was administered in concurrent group.
Clinicopathologic characteristics including age, weight loss,
histologic types, and clinical stage did not show significant
differences between two groups except for a higher proportion of
patients with ECOG performance status 2 in concurrent
group (3% vs. 27%, p=0.015). Overall toxicity was generally
acceptable with 1 treatment-related death from tracheoesophageal
fistula in induction group. The response rates after concurrent
CRT were 41% for induction group and 54% for concurrent
group, which showed no significant difference (p=0.560). With
median follow-up of 13 (1–92) months, there was a
trend toward an advantage for concurrent group in median
progression-free survival (6 months vs 8.3 months, p=0.067) and
overall survival (12 months vs. 14.5 months, p=0.059). In
multivariate analysis, only more than 10% weight loss within
6 months was significantly associated with poor survival (p=0.001).
In conclusion, the addition of induction chemotherapy to
concurrent CRT did not show any advantage over concurrent
CRT alone in locally advanced NSCLC.
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Keywords: non-small cell lung cancer, locally advanced, induction
chemotherapy, concurrent chemoradiotherapy
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Year: 2006, Volume: 53, Issue: |
Page From: 30, Page To: 36 |
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