Title: Clinical Outcome of Induction Chemotherapy and Simultaneous Chemo Radiotherapy in Stage IIIA or IIIB Inoperable Non-Small Cell Lung Cancer
Authors: Dr Preeya. V, Dr Devi Mohan
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.55
Abstract
Aims: Two meta-analyses have shown a survival advantage for the addition of concurrent chemotherapy to radiotherapy and other sequential radiochemotherapy in the treatment of inoperable advanced lung cancer. The aims of this study were to examine treatment outcomes (survival, time to progression, response rates and toxicity) in patients with lung cancer treated with sequential chemor adiation and to compare these with outcomes in patients treated with radiation alone.
Materials and Methods; Between December 2010 and November 2012, 138 patients of inoperable Stage 111A and Stage 111B Non small Cell lung cancer (NSCLC) were treated with chemoradiation.. Acute toxicity was recorded, with toxicity graded using the common toxicity criteria version4. The median age was 58 years. All patients were staged with computed tomography and brnchoscopy. After induction chemotherapy 68 patients were treated with radiation alone and 70 patients were treated concurrent chemo radiation. This was due to waiting list problems. The chemotherapy used was paclitaxel 60 mg/m2 weekly with radiotherapy, (the neo adjuvant dose was Paclitaxel 175 mg/m2 with cisplatin 75 mg/m2 3 weekly). External beam radiotherapy was given to the chest (40 Gy/20 fractions/4 weeks) followed by 10 Gy boost in 5 fractions.
Results: Patients benefited to an extent of 3.6 months of median time to progression and 3.42 months of mean survival time without major increases in toxicity. The frequent toxicity in our study was Grade 1 Esophagitis followed by grade 1 pneumonitis
Conclusion: There was a trend towards improved survival with concurrent chemoradiation in this cohort of patients that may become significant with longer follow-up.
Keywords: Lung carcinoma, chemoradiotherapy, outcome, time to progression, survival, toxicity.
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