Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Retrospective Analysis of Chemoradiotherapy for Limited-Stage Small-Cell Lung Cancer

제한병기 소세포암 환자의 항암화학방사선요법에 대한 후향적 분석

  • Lee, Jong-Hoon (Departments of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Sung-Hwan (Departments of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Su-Zy (Departments of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Joo-Hwan (Departments of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Hoon-Kyo (Departments of Medical Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Shim, Byoung-Yong (Departments of Medical Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine)
  • 이종훈 (가톨릭대학교 의과대학 성빈센트병원 방사선종양학교실) ;
  • 김성환 (가톨릭대학교 의과대학 성빈센트병원 방사선종양학교실) ;
  • 김수지 (가톨릭대학교 의과대학 성빈센트병원 방사선종양학교실) ;
  • 이주환 (가톨릭대학교 의과대학 성빈센트병원 방사선종양학교실) ;
  • 김훈교 (가톨릭대학교 의과대학 성빈센트병원 종양내과학교실) ;
  • 심병용 (가톨릭대학교 의과대학 성빈센트병원 종양내과학교실)
  • Received : 2009.07.03
  • Accepted : 2009.08.26
  • Published : 2009.09.30
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Abstract

Purpose: This study was designed to analyze the outcome and toxicity of thoracic radiation therapy (TRT) and chemotherapy for patients who suffer with limited-stage small-cell lung cancer (LS-SCLC). Materials and Methods: We retrospectively studied 35 patients with LS-SCLC. TRT was administered once daily (1.8 to 2 Gy per fraction) and it was directed to the primary tumor for a total 50 to 66 Gy in 6 to 7 weeks. The patients received four cycles of etoposide plus cisplatin. TRT was begun on day 1 of the first cycle of chemotherapy in the concurrent arm and after the fourth cycle in the sequential arm. Results: The median progression-free survival time was 16.5 months (95% confidence interval [CI], 9.0 to 24.1 months) for the sequential arm, and 26.3 months (95% CI, 16.6 to 35.9 months) for the concurrent arm. The 2-year progression-free survival rate was 16.0 percent for the sequential arm and 50.0 percent for the concurrent arm (p=0.0950 by log-rank test). Leukopenia was more severe and more frequent in the concurrent arm than in the sequential arm. However, severe esophagitis was infrequent in both arms. The radiotherapy was interrupted more frequently in the concurrent arm than in the sequential arm due to hematologic toxicities (p=0.001). Conclusion: This study suggests that concurrent TRT with etoposide plus cisplatin is more effective for the treatment of LS-SCLC than sequential TRT. However, there is a significant increase in the risk of toxicities, and radiotherapy was frequently interrupted in the concurrent arm due to hematologic toxicities.

목 적: 제한병기 소세포암 환자의 흉부방사선치료 및 항암치료의 성적과 부작용을 분석하고자 연구를 진행하였다. 대상 및 방법: 제한병기 소세포암으로 진단받고 동시항암화학방사선요법 혹은 순차적항암화학방사선요법을 받은 35명의 환자를 후향적으로 조사하였다. 방사선치료선량은 하루 1.8~2 Gy 분할선량으로 원발병소에 총 50~66 Gy 조사하였다. 환자군은 4주기 시스플라틴 및 에토포사이드 복합 항암치료를 받았다. 동시항암화학방사선요법군은 항암 제 1주기 첫 날에 흉부방사선치료를 시작하였고 순차적항암화학방사선요법군은 항암 제 4주기를 마친 후 에 흉부방사선치료를 시작하였다. 결 과: 순차적항암화학방사선요법군의 무진행생존시간의 중앙값은 16.5개월이었고 동시항암화학방사선요법군의 무진행생존시간의 중앙값은 26.3개월이었다. 동시항암화학방사선요법군의 2년 무진행생존율은 50.0%이었고 순차적항암화학방사선요법군의 2년 무진행생존율은 16.0%이었다(p=0.0950). 백혈구감소증의 정도와 빈도는 동시 항암화학방사선요법군에서 유의하게 높았다. 하지만, 심한 식도염의 빈도는 양군에서 모두 높지 않았다. 동시항암화학방사선요법군은 순차적항암화학방사선요법군에 비하여 빈번하게 혈액학적독성으로 치료가 중단되었다(p=0.001). 결 론: 본 연구에서는 동시항암화학방사선요법이 제한병기 소세포암 치료에서 순차적항암화학방사선요법보다 효과적이었다. 하지만, 동시항암화학방사선요법은 부작용을 유의하게 증가시켰다.

Keywords

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