Definitive Bimodality Concurrent Chemoradiotherapy in Patients with Inoperable N2-positive Stage IIIA Non-small Cell Lung Cancer.
- Author:
Jae Myoung NOH
1
;
Yong Chan AHN
;
Hyebin LEE
;
Hongryull PYO
;
Bokyong KIM
;
Dongryul OH
;
Hyojung PARK
;
Eonju LEE
;
Keunchil PARK
;
Jin Seok AHN
;
Myung Ju AHN
;
Jong Mu SUN
Author Information
- Publication Type:Original Article
- Keywords: Non-small cell lung carcinoma; Concurrent chemoradiotherapy; Stage IIIA-N2
- MeSH: Carboplatin; Carcinoma, Non-Small-Cell Lung*; Chemoradiotherapy*; Cisplatin; Consensus; Diagnosis; Disease Progression; Disease-Free Survival; Drug Therapy; Follow-Up Studies; Humans; Neoplasm Metastasis; Paclitaxel; Pneumonectomy; Treatment Failure
- From:Cancer Research and Treatment 2015;47(4):645-652
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: This study was conducted to evaluate the treatment outcomes following definitive bimodality concurrent chemoradiotherapy (CCRT) in patients with inoperable N2-positive stage IIIA (N2-IIIA) non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: From May 1997 to December 2012, 65 out of 633 patients with N2-IIIA NSCLC received bimodality therapy. The treatment modality was selected during/after neoadjuvant CCRT in 21 patients or primarily at diagnosis in 44 through a multidisciplinary consensus meeting. The median age was 65 years (range, 36 to 76 years). Sixty patients (92.3%) had clinically evident N2 disease, while 22 (33.8%) had multi-station N2 involvement. The median radiation therapy dose was 66 Gy in 33 fractions, while the dose was elevated to 72 Gy in 13 patients who had a treatment break due to delayed decision regarding resectability. The most frequent chemotherapy regimen was weekly paclitaxel or docetaxel plus cisplatin or carboplatin (54, 83.1%). RESULTS: During the median follow-up of 18.8 months (range, 1.6 to 173.1 months), 34 patients (52.3%) experienced disease progression, with distant metastasis being the most common first treatment failure pattern (23, 34.8%). The median and 2-year rates of progression-free survival were 18.8 months and 45.9%, respectively. The median and 2-year rates of overall survival were 28.6 months and 50.1%, respectively. CONCLUSION: Definitive bimodality therapy in patients with N2-IIIA NSCLC demonstrated favorable outcomes, while trimodality therapy could be considered for candidates for less than pneumonectomy.
