2037 Definitive radiation therapy for medically inoperable patients with stage I and II non-small cell lung cancer

280

Radiation O n c o l o g y , Biology. Physics

Volume 32, S u p p l e m e n t 1

2036 A PROSPECTIVE RANDOMIZED STUDY OF POSTOPERATIVE ADJUVANT CHEMO-RADIOTHERAPY (CT+RT) VS. RADIOTHERAPY(RT) ALONE IN RESECTED STAGE lI AND IHA NON-SMALL CELL LUNG CANCER(NSCLC) Chang Geol Lee.,M.D. Joo Hang Kim M . D . , Kyung Young f~hung M.D.,~ Doo x,"up I.ve M.D.3, Kil Dong K.im MD.;, Won Young Lee M.D2, Sung Kyu Kim M.D/, Sei Kyu Kim MD.% Gwi Eon Kim M.D. Department of Radiation Oncology ~, Internal Medicine ~ and Thoracic & Cardiovascular Surger3 ,3, Yonsei University College of Medicine, Yonsei Cancer Center, CPO Box 8044, Seoul, KOREA Objective : A prospective randomized study has been conducted to compare the results of treatment between CT÷RT and RT alone as an adjuvant setting in completely resected stage II and Ilia NSCLC. Ma!~rials and Methods : Patients who had completely resected stage II and Ilia NSCLC were randomized into a CT+RT aiTn(arm A) and a RT alone arm(arm B) as an adjuvant setting after stratification according to ceU type(squamous vs. non-squamous) and stage(lI vs. IliA). CT(Etopeside 100rag/m2 I.V. infusion dl-3, Cisplatin 20mg/m2 I.V. infusion dl-5, total 6cycles) was started in postop. 3 weeks with a 4 weeks interval. RT(5040cGy/5-6wks, 180cGy/fr) was started in postoperative 5 weeks after the first cycle of CT for group A and in postoperative 4 weeks for group B. A total of 69 patients were registered from Sep. 1990 to Jun. 1993. Sixty five of these patients were evaluable because 4 patients were ineligible due to distant metastasis before adjuvant treatment. Two patients who refused adjuvant treatment were included in this study to avoid selection bias. Results : Sixteen patients(48%) have received CT of more than 3 cycles and 51 patients(78%) have received RT of more than 50Gy. Four patients died due to treatment-related complications [broncho-pleural fistula 3(arm A:B=2:I), pneumonia l(arm A)]. Survival and the patterns of failure are as follows: ~edian Survival

CT÷RT(33)

RT(32)

P

Failure

CT+RT(33)

Overall

16.6~o

26.2~o

n.s.

Local

13~(4)

Stage

24.0~o{10 29.5~o(12) 14.4~o(23 17.8~o(20) 1 5 . 7 q o ( 2 1 )42Mo(20) 17 6qo(12 12Mo(12)

n.s. n.s. n.s.

L * D

9~(3)

I1 Ilia Pathology Squamous Non-squamous

n.s.

Distant

33~(11)

i ) \o. of patients

RT(32)

P

9~(3)

n.s.

0

n.s.

47~(15)

n.s.

n.s.:no~ s i g n i f i c a n t

Conclusion : There is n~ stati>tica[ sis{nificance in eithel tt~e ~eTall survival ol the patterns of failure between the CT+RT arm and RT ah~ne arm a* an adiuvant setting in resected
2037 DEFINITWE RADIATION" THERAPY FOR MEDICALLY INOPERABLE PATIENTS V,]TH STAGE I AND II NON-SMALL CELL LUNG CANCER K. Haya.kawa, N. Mitsuhashi, Y. Saito, Y. Nakayama, S. Katano, M. Furuta, H. Sakurai, T. Takahashi a n d H. Niibe. D e p a r t m e n t of Radiology & Radiation Oncology, G u n m a University School of Medicine, Gunma, Japan. Purpose: To evaluate the role of definitive r a d i a t i o n t h e r a p y (RT) in the t r e a t m e n t for medically i n o p e r a b l e p a t i e n t s with stage I-II n o n - s m a l l cell lung c a n c e r (NSCI C). Materials a n d Methods: From 1976 t h r o u g h I989, 84 p a t i e n t s with clinical stage I a n d II NSCLC were t r e a t e d with definitive RT alone at G u n m a University hospital. All p a t i e n t s w e r e t r e a t e d with 10 MV X-rays using a n t e r o - p o s t e r i o r parallel o p p o s e d fields. The total dose r a n g e d f r o m 60 Gy to 90 Gy (35 pts; 60-69 Gy, 39 pts; 70-74 Gy, 10 pts; >80 Gy) with once-dally s t a n d a r d fractionation. Results: The two a n d five-year survival rates were 74% and 31% for 28 p a t i e n t s ~ l t h stage I disease, as c o m p a r e d with 40% a n d 19% for 56 p a t i e n t s with stage lI respectively (p