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- Title
A prospective and randomized study of radiotherapy, sequential chemotherapy radiotherapy and concomitant chemotherapy-radiotherapy in unresectable non small cell carcinoma of the lung.
- Authors
Dasgupta, Anirban; Dasgupta, Chandan; Basu, Siddhartha; Majumdar, Anup
- Abstract
<bold>Purpose: </bold>Treatment of advanced Non small cell lung cancer (NSCLC) often produces dismal results. Combination of available treatment modalities has reportedly improved the outcome. A prospectively randomized trial was conducted, comparing combined treatment modalities versus radiotherapy alone, in treatment of unresectable NSCLC.<bold>Materials and Methods: </bold>A total of 103 patients were randomized to three groups. In group 'A', 32 patients received radiotherapy alone (6500 cGy/30 fraction). In group 'B', 35 patients received neoadjuvant chemotherapy (Cisplatin 80 mg/m2 on day 1 and Etoposide 100 mg/m day 1-3 intravenously q3 weeks for 3 cycles), followed by radiotherapy (6000 cGy/30 fractions) and 3 more cycles of Chemotherapy, with the same regimen. In group 'C', 36 patients received radiotherapy (5000 cGy/25 fractions) with concurrent chemotherapy (cisplatin 20 mg/m2 + Etoposide 75 mg/m2 intravenously on day 1-5 and day 22-26), followed by 2 more cycles of chemotherapy, q3 weeks with the same regimen.<bold>Results: </bold>Initial treatment responses were significantly higher in group 'B' (P < 0.05) and 'C' (P < 0.03), compared to group 'A'. Follow-up observations showed, that addition of chemotherapy brought down distant metastasis's from 62.5% (group 'A') to 48.6% (group 'B') and 44.4% (group 'C'). The median time to tumour progression also improved from 16 months (Group 'A') to 21 months (Group 'B' and 'C'). But 2 year follow up did not show any survival benefit. Acute toxicities were more frequent in group 'B' and 'C', but were manageable.<bold>Conclusion: </bold>Addition of chemotherapy with radiation in unresectable NSCLC improves response rates, time to tumour progression and disease free survival, though the same effect is not translated in overall survival.
- Subjects
LUNG cancer; CANCER treatment; THERAPEUTICS; RADIOTHERAPY; DRUG therapy; ANTINEOPLASTIC agents; LUNG cancer treatment; TREATMENT of lung tumors; CISPLATIN; CLINICAL trials; COMBINED modality therapy; COMPARATIVE studies; ETOPOSIDE; LUNG tumors; RESEARCH methodology; MEDICAL cooperation; RESEARCH; EVALUATION research; RANDOMIZED controlled trials; TREATMENT effectiveness
- Publication
Journal of Cancer Research & Therapeutics, 2006, Vol 2, Issue 2, p47
- ISSN
0973-1482
- Publication type
journal article
- DOI
10.4103/0973-1482.25849