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J Korean Cancer Assoc > Volume 27(3); 1995 > Article
Journal of the Korean Cancer Association 1995;27(3): 442-451.
국한성병기 소세포폐암의 흉부 방사선치료
박찬일, 김용호, 방영주, 허대석, 김노경
The Timing of Thoracic Radiotherapy for Limited Stage Small Cell Lung Cancer
Charn Il Park, Young Ho Kim, Yung Jue Bang, Dae Seog Heo, Noe Kyeong Kim
ABSTRACT
The purpose of this study was to evaluate the effect of the timing of thoracic radiotherapy in the combined modality therapy of limited stage small cell lung cancer with respect to local control and survivaL Two hundred and one patients with limited stage small cell lung cancer were treated at Seoul National University Hospital between April 1979 and February 1991. Of these, l12 patients received thoracic radiotherapy following 2 cycles of cyclophosphamide, adriamycin and vincristine( CAV) or VP-16, ifosphamide and cisplatin(VIP) alternating CAV schedule(sequential CT/RT) and 89 patients received thoracic radiotherapy concurrently with the 3rd cycle of etoposide and cisplatin(EP) or alternating EP/CAV schedule(concurrent CT/RT). Thoracic radiotherapy consisted of 40-45 Gy in 4-5 weeks. All patients received prophylactic cranial ir- radiation with 25 Gy in 10 fractions over 2 weeks. The over survival at 2 years for all 201 patients was 29.2%, with a median survival of 17 months. The median survival was 16 months for the sequential CT/RT and 18 months for the concurrent CT/RT. The survival rate in the sequential CT/RT schedule was 26.1% at 2 years, and 16.2% at 5 years, as compared with 32.5%, and 22.8% at 2 years and 5 years, respectively, in the concurrent CT/RT schedule. However, there was no significant difference between the two schedules(p=0.11). The local control rates for alternating EP/CAV regimens with concur- rent thoracic radiotherapy was significantly higher than that for other regimens(p=0.003). Seventy-two(48%) patients had local failure as the first site of failure, whereas 39(26%) patients had distant failure without local failures. Thirty-eight(26%) patients had local and distant failure. These results indicate that early, concurrent thoracic radiotherapy with alternating EP/ CAV regimens have the improved local control rates and a trend of the better survival in the combined modality treatment of limited stage small cell lung cancer.
Key words: Limited stage small cell lung cancer, Thoracic radiotherapy, Timing, Chemotherapy
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