Eş zamanlı kemoradyoterapi uygulanan opere edilemeyen lokal ileri evre küçük hücreli dışı akciğer kanserinde indüksiyon ve konsalidasyon kemoterapisinin yeri: retrospektif çalışma

Year 2019, , 40 - 46, 31.03.2019

Semiha Urvay , Birsen Yücel

https://doi.org/10.21601/ortadogutipdergisi.467677

Abstract

Amaç: Bu
çalışmanın amacı eşzamanlı kemoradyoterapi ile tedavi edilen küçük hücreli dışı
akciğer kanserinde (KHDAK) indüksiyon veya konsalidasyon kemoterapilerinin
yalnızca kemoradyoterapi (KRT) ile karşılaştırıldığında sağkalıma etkinliğinin
araştırılmasıdır.

Gereç ve Yöntemler: Lokal
ileri evre KHDAK tanısı ile eşzamanlı kemoradyoterapi ±
indüksiyon/konsalidasyon tedavisi alan 114 hastanın dosyaları retrospektif
olarak incelendi. İndüksiyon veya konsalidasyon tedavisi olarak platin temelli
ikili kemoterapi rejimi kullanıldı. 60-66 Gy torasik radyoterapi ile eşzamanlı
tek ajan platin( sisplatin veya karboplatin), platin+etoposid veya
platin+taksan içeren kemoterapi protokolleri uygulandı. Sonuçlar: Çalışmaya
dahil edilen 114 hastanın 32 (28%)'si KRT; 54 (47%) 'si indüksiyon ve 28 (25%)'
si konsalidasyon kolundaydı. Tüm hastalar için ortanca sağkalım 21,9±14.0
ay; 2 ve 3 yıllık sağkalım oranları ise %46 ve %33 olarak bulundu. KRT;
indüksiyon ve konsolidasyon kemoterapisi alan 
hastaların ortanca  sağkalımları
sırası ile 29,7±8,8 ay; 23±2,9 ay ve 16,8±3,5 ay olarak saptanmış olup anlamlı
farklılık yoktu( p=0,54). 2 yıllık  
sağkalım oranları  KRT kolu için
53%; indüksiyon kolu için 50% ve konsalidasyon kolu için 32% ( p=0,48) ; 3
yıllık sağkalım oranları ise sırası ile 40%, 33% ve 25% ( p=0,40) olarak
saptanmış olup benzerdi.

Sonuç: Bu
retrospektif çalışmada, eşzamanlı kemoradyoterapiye eklenen  indüksiyon veya konsolidasyon kemoterapisinin
genel sağkalımı uzatmadığı gösterilmiştir. Rezeke edilemeyen evre III KHDAK
için standart tedavi hala eş zamanlı kemoradyoterapidir.

Keywords

küçük hücreli dışı akciğer kanseri, kemoradyoterapi, indüksiyon, konsalidasyon

Induction or consolidation chemotherapy for unresectable stage ııı non-small-cell lung cancer patients treated with concurrent chemoradiation: a retrospective study

Abstract

Aim: The objective of this
study is to demonstrate the efficacy of induction or consolidation chemotherapy
on survival in locally advanced non-small cell lung cancer ( NSCLC) patients
who were treated by curative concurrent chemoradiotherapy (CCRT).

Material and Methods: Patients were randomised to
CCRT, induction chemotherapy followed by CCRT or CCRT followed by consalidation
chemotherapy retrospectively. A platinum-based doublet cytotoxic chemotherapy
regimen used as induction/consalidation. Patients who received 60 Gy or more were included
in the study. These patients had received two or more cycles of platinum-based
chemotherapy concurrently with definitive radiation therapy.

 

Results:  A total of 114 patients were included in the
study. 32 (28%)
patients were in CCRT arm; 54 (47%) patients were in induction arm and 28 (25%)
patients were in consalidation arm.Median overall survival (OS) was found as 21.9±14.0 months
and  2 year and 3-year survival as %46
and 33% in all patients. Median OS did not differ between  arms; with a median OS of 29.7±8.8 months, 23±2.9
months and 16.8±3.5 months in the CCRT arm, in the induction arm  and in the consolidation arm (p:0.54).
The 2 years OS was 53%, 50% and  32% (p:0.48)
and 3 years OS was 40%, 33% and 25%  ( p:0.40)
in the CCRT arm,  the induction arm in
the consalidation arm  without a
significiant difference.

Conclusion: In this retrospective
study, platin-based chemotherapy as induction or consolidation with concurrent
chemoradiotherapy failed to further prolong OS. The standart of care for
unresectable stage III NSCLC  is still concurrent
chemoradiotherapy .

Keywords

non small cell lung canser, chemoradiotherapy, induction, consalidation

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