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《Chinese Journal of Lung Cancer》 2006-03
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Clinical trial of concurrent low-dose chemotherapy plus radiation vs sequential chemoradiotherapy for unresectable stage Ⅲ non-small cell lung cancer

WU Hongyu, ZHOU Daoan, WU Qiongya, CAI Yong, LIU Yu, JIANG Jing. Division of Radiotherapy, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, P.R.China  
Background and objective Concurrent chemotherapy plus radiotherapy is a trend in treatment of non-small cell lung cancer (NSCLC), but the treatment program is rather complicated and the toxicity is more severe than chemotherapy or radiotherapy alone. The aim of this study is to evaluate the early response and toxicity of concurrent chemoradiotherapy. Methods Eighty unresectable stage ⅢA--ⅢB NSCLC patients pathologically proved were randomly divided into 2 groups. Group A: patients were treated with concurrent chemotherapy of vinorelbine (12.5mg/m~2, on days 1, 8, 29, 36) and cisplatin (40mg/m~2, on days 1, 8, 29, 36) (NP regimen) plus conventional radiotherapy. Patients were irradiated at 1.8--2.0Gy/Fx daily, 5 days per week. The total dose was 60Gy/30--33 Fx. After the radiation, 3 cycles of NP regimen were performed, but the dose of vinorelbine was 25mg/m~2. Group B: patients received sequential chemoradiotherapy. At first radiation was performed as same as group A. Then chemotherapy of NP (NVB 25mg/m~2, on days 1 and 8, DDP 80mg/m~2, on day 1) was followed for 4--5 cycles. Results The overall response rate in concurrent and sequential groups was 80.0% and 57.5% respectively (χ~2=4.71, P0.05). Incidences of grade Ⅲ--Ⅳ acute radiation esophagitis and leukopenia were 47.5% and 65.0% in group A, and 25.0% and 42.5% in group B respectively (P0.05). The acute radiation pneumonitis rate was 32.5% in group A and 20.0% in group B (P0.1). Conclusion Concurrent chemoradiotherapy is well tolerated in most unresectable stage ⅢA--ⅢB NSCLC patients. Its early response is better than sequential chemoradiotherapy.
【CateGory Index】: R734.2
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