Abstract
INTRODUCTION: There is considerable debate over ideal treatment approach for inoperable stage III non-small cell lung carcinoma. Accelerated radiotherapy is an emerging modality based on it's radio-biological advantage of inhibiting accelerated repopulation and negate the development of radioresistance. .Our study was aimed at comparing the response rate and toxicity pattern between concurrent chemoradiotherapy and accelerated radiotherapy in non-resectable stage III NSCLC patient who have already received induction chemotherapy. MATERIALAND METHODS: Patients with histologically proven non-metastatic, inoperable stage III Non-small cell carcinoma of lung were 2 2 randomized into two groups and was given three cycles of induction chemotherapy with paclitxel (175mg/m ) and cisplatin (80mg/m ). After that 2 patients of control arm received EBRT at a dose of 66Gy (2Gy/fraction/day, 5 days in a week) with concurrent cisplatin (40mg/m ) weekly and patients of study arm received EBRT alone at a dose of 66 Gy (2 Gy /fraction/day, 6 days in a week).Patients were evaluated weekly for acute toxicity during radiation therapy, then six weeks after completion of treatment for response assessment and thereafter every three months for at least twelve months . RESULTS: Overall response rate (Complete response+ Partial response) was higher in study arm (62.5% VS 69.5%,p-value 0.963). Signicantly less higher grade of acute pharyngeal and esophageal toxicity was seen in accelerated radiotherapy arm(45.8% vs 13%,p-value 0.033) than concurrent chemoradiotherapy arm. DFS,PFS were comparable between two arms. CONCLUSION: In the treatment of inoperable stage III NSCLC, after induction chemotherapy both the Accelerated radiotherapy and concurrent chemoradiotherapy were comparable in terms of loco-regional control, toxicity prole, disease free survival and progression free survival.
Published Version
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