Abstract
This study investigated pre- and post-treatment tumor and lymph node dimension response rates and differences between side-effect profiles in patients with locally advanced inoperable nonsmall-cell lung cancer (NSCLC) receiving radiotherapy (RT) and concurrent chemotherapy (CT). A total of 30 inoperable patients who had not previously received RT and having a mean age of 58.73±8.65 years with sufficient hematological reserves and normal hepatic and renal functions were included in the study. Those with pleural effusion, supraventricular lymph node metastasis, and N3 lymph node involvement were excluded. Group I (n=15) received a 21-day 75 mg/m2 cisplatin (D1) and 15 mg/m2 vinorelbine (D1, D8), whereas Group II (n=15) received 45 mg/m2 paclitaxel and AUC2 carboplatin weekly. RT was administered using a linear accelerator device with the 3D conformal RT technique at 6-18 MV energy with a 1.8-2 Gy fraction for 6-7 weeks. Patients were randomized into Group I receiving RT and concurrent cisplatin-vinorelbine and Group II receiving weekly paclitaxel-carboplatin CT. Pre- and post-treatment tumor and lymph node dimensions significantly differed in both groups (p<0.001 and p<0.01, respectively). No significant change was observed in post-RT tumor and lymph node dimensions in terms of applied CT regimens (p>0.05). The significant response achieved with concurrent RT and CT in groups I and II in the local advanced stage of NSCLC is important for local tumor control. Responses to treatment in the group of two arms did not differ.
Highlights
Cancer remains an important health problem with regard to the inconclusive nature of basic therapeutic principles and cost
Patients were randomized into Group I receiving RT and concurrent cisplatin–vinorelbine and Group II receiving weekly paclitaxel–carboplatin CT
Pre- and post-treatment tumor and lymph node dimensions significantly differed in both groups (p
Summary
Cancer remains an important health problem with regard to the inconclusive nature of basic therapeutic principles and cost. Nonsmall-cell histology constitutes approximately 80% of all lung cancers [1], and 25%–40% of patients with nonsmall-cell cancer (NSCLC) have advanced local Stage III disease at the time of diagnosis [2]. Majority of patients with Stage III NSCLC are not suitable for surgical resection and are generally treated with the combination of chemotherapy (CT) and radiotherapy (RT) [3]. CT is regarded as the standard therapeutic approach in patients with local advanced inoperable NSCLC, the order of administration of RT and CT is still uncertain [4]. Inturn approach is largely associated with the eradication of systemic metastases, whereas better local control in patients treated with concurrent chemoradiotherapy results in better survival [4]
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