제한병기 소세포 폐암의 복합화학요법과 흉부 방사선요법의 동시병용치료와 순차적 병용 치료의 비교

Abstract

Between June 1988 and March 1997, 57 patients were enrolled and 56 patients were evaluated. We divided these patients as concurrent and sequential groups according to the time of chest irradiation. All of 29 patients in the concurrent group received PE combination chemotherapy (25 mg/㎡ cisplatin and 120mg/㎡ etoposide for 1~3 days). Chemotherapy was repeated every 4 weeks for total 4 courses. Radiation of 60 Gy was given with the first course of chemotherapy. The sequential group was composed of 27 patients: 10 patients received PE combination chemotherapy, 4 patients received VIP combination chemotherapy (75 mg/㎡ etoposide, 1.2 g/㎡ ifosfamide, 20 mg/㎡ and cisplatin for 1-4 days), 2 patients received CAV combination chemotherpay (1 g/㎡ cyclophosphamide, 45 mg/㎡ doxorubicin and 1.4 g/㎡ vincristine for 1 day) and 11 patients received CAV/PE alternating chemotherapy. Chemotherapy was repeated for 6 to 8 courses. After 4 weeks of chemotherapy, chest radiation therapy was started. Total dose of radiation ranged from 45 Gy to 63 Gy. The survival rate in the concurrent group was 31.8% at 2 years and 23, 8% at 5 years, compared with 25.6% and 12.6% in the sequential group, respectively. However, there were no significant differences between the two groups. The local control rates for the concurrent group was higher than those for sequential group. However, the difference was not significant. In concurrent group, 4 patients (19.0%) had local failure compared to 8 patients (42.5%) in sequential group.