Combined chemoradiotherapy in the treatment of unresectable locally advanced non small cell lung cancer (NSCLC)‎

Abstract EN

Aim : The aim of the study was to assess the response of locally advanced NSCLC to combined chemoradiotherpay and evaluate the response to neoadjuvant chemotherapy before the combined approach, and assessment of the treatment toxicities according to WHO criteria(11) with evaluation of progression free survival and one year survival .

Materials and Methods: This study included previously untreated patients with locally advanced unresectable non metastatic NSCLC (stage IIIA, IIIB), according to TNM staging system.

From January 2001 to November 2002, 30 patients with histopathologically proven NSCLC, received (1) neoadjuvant chemotherapy by giving 2 cycles of gemcitabine-cisplatin combined regimen with an interval of 21 days in the following doses: Cisplatin 80 mg / m2 on day one and gemcitabine dose 1250 mg / m2 on days 1 and 8.

(2) concomitant chemo radiotherapy by giving : (A) chemotherapy in the following doses: gemcitabine dose 300 mg / m2 on days 1, 8, 22 and 29and cisplatin 60 mg/m2 on days 1 and 22.

(B) radiotherapy : a total dose of 60 Gy / 6 weeks, administrated in daily fractions of 2 Gy for 5 days / week.

Results : The following results were obtained from this study : None of the patients showed complete response, 53.3% (16 / 30) of the patients attained partial response, 33.3% (10 / 30) had no response, and only (4 / 30) 13.3% had progressive disease.

Response to treatment was significantly higher in patients with performance status 80% or above, stage IIIA patients and in patients with poorly differentiated tumours.

The progression free survival at one year was 26.7% and the one year survival was 60%.

Toxicities to treatment were generally within an acceptable level, except esophagitis it was 74%.

Conclusion : Further trials using lower doses of chemotherapy and different radiation schedules with inclusion of more patients and longer duration of follow up are needed for better evaluation of these results.