TY  - JOUR
T1  - Comparison of definitive chemoradiotherapy and surgical results in local advanced (stage IIIa and IIIb) non-small cell lung cancer: single-center experience
TT  - Lokal ileri (Evre IIIA ve IIIB) küçük hücreli dışı akciğer kanserinde definitif kemoradyoterapi ile cerrahi sonuçlarının karşılaştırılması: Tek merkez deneyimi
AU  - Yılmaz, Mukaddes
AU  - Yücel, Birsen
AU  - Kirman, Derya
AU  - Akdoğan, Orhun
AU  - Yazıcı, Ozan
PY  - 2019
DA  - March
Y2  - 2019
DO  - 10.7197/223.vi.540804
JF  - Cumhuriyet Medical Journal
JO  - CMJ
PB  - Sivas Cumhuriyet University
WT  - DergiPark
SN  - 1305-0028
SP  - 69
EP  - 74
VL  - 41
IS  - 1
LA  - en
AB  - Objective: Discussions regarding thetreatment of stage III non-small cell lung cancer (NSCLC) are still ongoing inthe literature. It is important to evaluate the developments in radiotherapyand surgery along with the data in real life regarding stage III NSCLC. The aimof this study is to evaluate the treatment approaches and real-life data instage IIIA and IIIB local advanced NSCLC.Method: The files of 47 patients withlocal advanced stage IIIA and IIIB NSCLC, who were followed up in the GaziUniversity Faculty of Medicine, Medical Oncology Clinic between February 2016and May 2018, were retrospectively evaluated. Results: As the primary treatment,definitive chemoradiotherapy (CRT) to 27 (57%) patients and surgical treatmentto 20 (43%) patients were applied. It was observed that the performance status(p=0.010) of the patients who underwent CRT was statistically significantlyworse, active smoking (p=0.033) was higher, and had a more advanced lymph nodestage (p=0.052). In the univariate analysis, it was determined that lymph nodestatus (p=0.011), performance status of the patients (p=0.0247), and treatmentmodality of patients (p=0.001) were the prognostic factors affecting survival.The 1-year overall survival rates and median survival of the patients were 85%and 23 months in the surgical group respectively, and 41% and 10 months in thedefinitive CRT group. In the multivariate analysis, surgery was found to be abetter independent prognostic factor than CRT (HR: 2.72, 95% CI: 1.27-5.82,p=0.010). Conclusions: It wasobserved that the results of the patients, who were found to be respectable asa result of the clinical experience in stage III NSCLC patient group, werebetter. The mediastinal lymph node involvement site, especially N3 lymph nodesite, and the patient performance are among the important factors thatdetermine the prognosis in stage III NSCLC.
KW  - non-small cell lung canser
KW  - surgery
KW  - chemoradiotherapy
N2  - Amaç:Literatürde evre III küçük hücreli dışıakciğer kanseri (KHDAK) tedavisi ile ilgili tartışmalar halen sürmektedir.Radyoterapi ve cerrahideki gelişmeler ile evre III KHDAK gerçek yaşamdakiverilerin değerlendirilmesi önem arz etmektedir. Evre IIIA ve IIIB lokal ileriKHDAK’nde tedavi yaklaşımlarının ve gerçek yaşam verilerinin değerlendirilmesiamaçlanmıştır.Yöntem:Şubat 2016 – Mayıs 2018 tarihleriarasında Gazi Üniversitesi Tıp Fakültesi Medikal Onkoloji kliniğinde takipedilen lokal ileri evre IIIA ve IIIB KHDAK 47 hastanın dosyaları retrospektifolarak değerlendirildi.Bulgular:Primer tedavi olarak 27 (%57) hastadefinitif kemoradyoterapi (KRT), 20 (%43) hastaya cerrahi tedavisiuygulanmıştı. KRT uygulanan hastaların, performans durumunun (p=0.010) istatistikselolarak anlamlı derecede daha kötüydü, aktif sigara içiminin (p=0.033) dahafazla olduğu ve daha ileri lenf nodu evresine (p=0.052) sahip olduğugörülmüştür. Tek değişkenli analizde lenf nodu durumu (p=0.011), hastalarınperformans durumu (p=0.0247) ve hastaların tedavi modalitesi (p=0.001) sağkalımı etkileyen prognostik faktörler olarak tespit edilmiştir. Hastaların 1yıllık genel sağ kalım oranları ve medyan sağ kalımı, cerrahi uygulanan gruptasırasıyla 85% ve 23 ay, definitif KRT uygulananlarda 41% ve 10 ay olarak tespitedilmiştir. Çok değişkenli analizde cerrahi yapılması KRT’ye göre bağımsız dahaiyi prognostik faktör olarak belirlenmiştir (HR: 2.72, 95% CI: 1.27-5.82,p=0.010).Sonuç:Evre III KHDAK hasta grubunda klinikdeneyimimiz sonucunda rezektabl olan hastaların sonuçlarının daha iyi olduğugörülmektedir. Mediasten lenf nodu tutulum bölgesi özellikle N3 lenf nodubölgesi ve hasta performansı evre III KHDAK’ inde prognozu belirleyen önemlifaktörlerdendir.
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UR  - https://doi.org/10.7197/223.vi.540804
L1  - https://dergipark.org.tr/en/download/article-file/683093
ER  -