Yamanashi Keiji, Okumura Norihito, Takahashi Ayuko, Nakashima Takashi, Matsuoka Tomoaki, Yokoyama Toshihide, Itasaka Satoshi
Department of Thoracic Surgery, Kurashiki Central Hospital, Kurashiki, Japan.
Kyobu Geka. 2018 Aug;71(8):563-572.
The aim of this study is to investigate the outcomes of induction chemoradiotherapy (ICRT) followed by surgery in patients with non-small cell lung cancer( NSCLC).
We retrospectively analyzed consecutive patients with NSCLC who underwent ICRT followed by surgery at our hospital between January 2006 and December 2015.
A total of 102 patients were eligible for evaluation (cStage/I B/II A/II B/III A/III B, 1/8/14/75/4). The median age was 66 years. Forty-one patients had adenocarcinoma, 42 patients had squamous cell carcinoma, and 19 patients had others. The regimen consisted of carboplatin and paclitaxel in 94 patients, and the others in 8 patients plus concurrent radiation at a dose of 28 Gy in 1 patient, 30 Gy in 28 patients, 40 Gy in 42 patients, 45 Gy in 3 patients, and 50 Gy in 28 patients. Major response was obtained in 84 patients. Grade 3/4 toxicity of ICRT reported in 57 patients. The 5-year relapse-free and overall survival rate was 51.4% and 62.7%, respectively.
ICRT (carboplatin and paclitaxel plus concurrent standard radiation) followed by surgery in NSCLC can be safely performed and may contribute to satisfactory outcomes in locally advanced NSCLC. It is likely that 28~50 Gy radiation dose contributes to satisfactory outcomes in ICRT.
本研究旨在调查非小细胞肺癌(NSCLC)患者接受诱导放化疗(ICRT)后手术的疗效。
我们回顾性分析了2006年1月至2015年12月期间在我院接受ICRT后手术的连续NSCLC患者。
共有102例患者符合评估条件(临床分期/ⅠB/ⅡA/ⅡB/ⅢA/ⅢB,1/8/14/75/4)。中位年龄为66岁。41例为腺癌,42例为鳞癌,19例为其他类型。94例患者的治疗方案为卡铂和紫杉醇,8例患者的方案为其他,其中1例患者同步放疗剂量为28 Gy,28例为30 Gy,42例为40 Gy,3例为45 Gy,28例为50 Gy。84例患者获得主要缓解。57例患者报告了ICRT的3/4级毒性。5年无复发生存率和总生存率分别为51.4%和62.7%。
NSCLC患者接受ICRT(卡铂和紫杉醇加同步标准放疗)后手术可安全进行,并可能为局部晚期NSCLC带来满意的疗效。28~50 Gy的放疗剂量可能有助于ICRT取得满意的疗效。