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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.

Authors
Lee, HW; Choi, JH; Lim, HY; Park, JS; Kim, HC; Kang, S; Oh, YT; Chun, M; Sheen, SS; Oh, YJ; Park, KJ; Hwang, SC
Citation
Neoplasma, 53(1):30-36, 2006
Journal Title
Neoplasma
ISSN
0028-26851338-4317
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.
MeSH terms
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*Carcinoma, Non-Small-Cell Lung/drug therapy*Carcinoma, Non-Small-Cell Lung/mortalityCarcinoma, Non-Small-Cell Lung/radiotherapy*Cisplatin/therapeutic useCombined Modality TherapyEtoposide/therapeutic useHumansIfosfamide/therapeutic useLung Neoplasms/drug therapy*Lung Neoplasms/mortalityLung Neoplasms/radiotherapy*Retrospective StudiesSurvival AnalysisTreatment Outcome
PMID
16416010
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Hematology-Oncology
Journal Papers > School of Medicine / Graduate School of Medicine > Radiation Oncology
Journal Papers > School of Medicine / Graduate School of Medicine > Pulmonary & Critical Care Medicine
Journal Papers > School of Medicine / Graduate School of Medicine > Medical Science
AJOU Authors
이현우최진혁박준성김효철강승희오영택전미선신승수오윤정박광주황성철
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