Concurrent Vs Sequential Chemoradiotherapy For Unresectable Stage â…¢ Non-small Cell Lung Cancer

Purpose: To compare the efficacy and side effects of concurrent and sequential chemoradiotherapy for unresectable stage III NSCLC. Methods :80 pathologically proved IIIA, IIIB stage unresectable non-small cell lung cancer patients were divided randomly into 2 groups. Group A patients were treated with concurrent chemotherapy navelbine + cisplatin NP plus conventional radiotherapy from the first day, NVB12.5mg/m~2, d1,8,29,36, v; DDP40mg/m~2, d1,8,29,36, i.v, patients were irradiated 1.8-2.0Gy/Fx/d, 5 days per week, the total dose was 60Gy/30-33Fx. After the radiation, chemotherapy was continued to be performed for 3 courses, but the agents were changed to full dose. They were NVB25mg/m~2, d57,64;84,91; 111,118; DDP80mg/m~2, d57,84,111. Group B patients received sequential chemoradiotherapy. Radiotherapy began from the beginning and was as same as Group A. Chemotherapy of NP (NVB25mg/m~2, d1,8; DDP80mg/m2, d1) was followed for 4 courses. Results: The overall response rates of concurruent and sequential groups were 80% and 58% respectively, χ~2=4.71, p <0.05. Grade 3-4 acute radiation esophagitis and leucopenia occurring rates were 47.5% ,65% in group A and 25%,43% in group B patients respectively, p <0.05. The difference was statistically significant. The acute radiation pneumonitis was observed in 32.5% group A and 20% group B patients, 0.1< p <0.25. Conclusions: Concurrent chemoradiotherapy is well tolerated in most IIIA, IIIB stage unresectable non-small cell lung cancer patients. Its early response is better than sequential chemoradiotherapy. Remote results await further follow-up.