Abstract
To determine survival of patients with stage IIIA/B non-small cell lung cancer considering disease stage and treatment methods. A total of 304 patients with non-small cell lung cancer were treated at the Department of Thoracic Surgery and Oncology, Institute of Oncology, Vilnius University, in 2000-2004. Stage IIIA (T3N1-2M0) cancer was diagnosed for 193 (63.5%) patients and stage IIIB (T4N0-1M0) cancer was diagnosed for 111 (36.5%) patients. There were 277 (91.1%) males and 27 (8.9%) females. According to morphology, there were 219 (72%) patients with squamous cell lung cancer, 80 (26.3%) with adenocarcinoma, and 5 (1.7%) patients with large cell carcinoma. Surgery was performed in 145 patients: 84 (57.9%) patients underwent lung resection (T3-4N0-1M0), 51 (35.2%) patients - thoracotomy, and 10 (6.7%) patients - other palliative thoracic procedures (mediastinotomy, pleurectomy, mediastinoscopy). Forty-eight (30.2%) patients were treated with radiation therapy with total doses of >40 Gy and 58 (36.5%) patients were treated with radiation therapy with total doses of <40 Gy. Fifty-four (33.9%) patients were treated with Gemzar and cisplatin and 19 (11.9%) patients were treated with etoposide and cisplatin. Overall median and mean survival was 7.8 months (95% CI, 6.8 to 8.8) and 9.9 months (95% CI, 9.0 to 10.9), respectively. The median and mean survival of patients with stage IIIA cancer was 8.3 months and 10.4 months, respectively, and that of patients with stage IIIB cancer - 6.4 months and 9.0 months, respectively (P < or =0.05). The median survival of the patients with stage IIIA cancer who received a combination of operation, chemotherapy, and radiation therapy with a total dose of >40 Gy was 14.4 months (mean, 14.7 months), and the median survival of those who received operation, chemotherapy, and radiation therapy with a total dose of < or =40 Gy was 9.7 months (mean, 14.1 months); the median survival of the patients who underwent surgery alone was 4.9 months (mean, 6.7 months) (P=0.004 and P=0.007), respectively. There was a significant difference in the median survival comparing the patients with stage IIIB cancer who underwent surgery alone and those who received a combination of radiation therapy and chemotherapy (median survival of 5.0 months [mean, 8.1 months] versus 16.8 months [mean, 17.6 months], respectively; P < or =0.05). Disease stage had an influence on the survival of patients with non-small cell lung cancer: patients with stage IIIA (T3N0-1M0) cancer without metastases to mediastinal lymph nodes (N factor) survived longer than patients with stage IIIB (T4N1-2M0) cancer, where not only N factor had an impact but T factor as well. Better treatment outcomes, i.e. longer survival, can be achieved when a combination of three treatment types - surgery, chemotherapy, and radiation therapy - is applied to patients with stage IIIA or IIIB non-small cell lung cancer. The patients with stage IIIA disease who received surgery and radiation therapy (total dose, >40 Gy), and combinations of surgery, chemotherapy, and radiation therapy and second-line chemotherapy showed a significantly longer survival than those who received surgery alone.
Highlights
Fifty-four (33.9%) patients were treated with Gemzar and cisplatin and 19 (11.9%) patients were treated with etoposide and cisplatin
Overall median and mean survival was 7.8 months and 9.9 months, respectively
The median survival of the patients with stage IIIA cancer who received a combination of operation, chemotherapy, and radiation therapy with a total dose of >40 Gy was 14.4 months, and the median survival of those who received operation, chemotherapy, and radiation therapy with a total dose of ≤40 Gy was 9.7 months; the median survival of the patients who underwent surgery alone was 4.9 months (P=0.004 and P=0.007), respectively
Summary
Plaučių vėžys Lietuvoje kaip ir visame pasaulyje moterų. III stadijos nesmulkialąstelinis plaučių vėžys yra viena pagrindinių vyrų onkologinių ligų, nors yra pagrindinis klinikinių krūtinės onkologijos tyrimų. Nesmulkialąstelinis plaučių vėžys yra dažniausias ir sudaro apie [80–85] proc. Kai yra pradinė ligos stadija, klinikinių simptomų nebūna arba jie yra neryškūs, todėl į gydytojus ligoniai kreipiasi per vėlai ir diagnozuojamas vėlyvųjų stadijų plaučių vėžys. Ligonių nustatomas III ar IV stadijos plaučių vėžys, todėl išgyvenamumo trukmė yra gana maža, nors taikomi įvairūs gydymo būdai. Sergančiųjų plaučių vėžiu, pasaulyje – nuo 15 iki 25 proc. Daugelyje pasaulio šalių taip pat Lietuvoje onkologai nėra patenkinti šios ligos gydymo rezultatais, nes mirtingumas nuo plaučių vėžio dar didelis. Chirurginis gydymas yra pirmiausia parenkamas gydymo būdas visiems ligoniams, sergantiems ankstyvųjų stadijų nesmulkialąsteliniu plaučių vėžiu, tačiau dėl kitų ligų, blogos bendrosios ligonių būklės jis tinka tik vienam trečdaliui šių ligonių. Tyrimo tikslas – nustatyti ligonių, sergančių nesmulkialąsteliniu IIIA ir IIIB stadijų plaučių vėžiu, gyvenimo trukmę atsižvelgiant į ligos išplitimą bei taikyto gydymo būdus. Į pirmąją tiriamąją grupę įtraukti ligoniai, kuriems skirtas cheminis ir spindulinis gydymas ar sudėtinis (chirurginis, cheminis ir spindulinis)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
