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Year : 2006  |  Volume : 2  |  Issue : 2  |  Page : 47-51

A prospective and randomized study of radiotherapy, sequential chemotherapy radiotherapy and concomitant chemo therapy-radiotherapy in unresectable non small cell carcinoma of the lung

Department of Radiotherapy, Institute of Post Graduate Medical Education and Research, Kolkata, India

Correspondence Address:
Anirban Dasgupta
16, Ramdhan Bose Road, Sonarpur, Kolkata-700 149
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1482.25849

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Purpose: 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. Materials and Methods: 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 (ciplatin 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. Results: 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. Conclusion: 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.

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