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김태원 ( Tae Won Kim ),이정신 ( Jung Shin Lee ),정병학 ( Byung Hak Jung ),윤환중 ( Hwan Jung Yun ),장대영 ( Dae Young Zang ),이제환 ( Je Hwan Lee ),김성배 ( Sung Bae Kim ),김상위 ( Sang We Kim ),서철원 ( Cheol Won Suh ),이규형 ( K 대한내과학회 1998 대한내과학회지 Vol.54 No.5
Objectives: The poor survival rates among patients receiving surgery alone for stages II and III non-small cell lung cancer prompted several trials of adjuvant therapy after resection. We performed a prospective phase II study in patients with stage II-IIIA non-small cell lung cancer after resection to evaluate the feasibility, activity and toxicity of the postoperative sequential MVP chemotherapy and radiotherapy. Methods: Between February 1991 and May 1995, 60 patients with resected stage II, IIIA non-small cell lung cancer received 2 cycles of MVP combination chemotherapy (Mitomycin-C 6 mg/m², Vinblastine 6 mg/m², Cisplatin 60 mg/m) within 3 weeks after surgery, followed by thoracic irradiation (5,040 cGy after complete resection and 900 cGy booster to microscopically positive resection margin at 1.8 Gy per fraction) within 3-4 weeks after chemotherapy. Results: Forty nine men and 11 women with a median age of 60.5 years (range 33-81 years) were included. During the median follow-up period of 828 days (61-2,015 days), 25 patients had developed recurrence. Among the 25 failures, 3 were local relapse only and 20 were distant metastasis only and 2 had both local and distant sites of recurrence. Three-year overall survival and event-free survival were 43% and 37%, respectively. Neutropenia of grade I-II was observed only in 13 patients. Eleven patient showed grade I-II radiation pneumonitis and 32 had grade I-II radiation esophagitis, Conclusion: Postoperative sequential MVP chemotherapy and radiotherapy in resected stage II-IIIA non-small cell lung cancer is well-tolerated and shows interesting activity,
장대영(Dae Young Zang),이정신(Jung Shin Lee),김태원(Tae Won Kim),정병학(Byung Hak Jung),윤환중(Hwan Jung Yun),최종수(Jong Soo Choi),박진희(Jin Hee Park),이동숙(Dong Sook Lee),이제환(Je Hwan Lee),김성배(Sung Bae Kim),김상위(Sang We Ki 대한내과학회 1998 대한내과학회지 Vol.54 No.1
N/A Background: Although small cell lung cancer is a chemosensitive disease, it grows rapidly and relapses frequently. Even with optimum treatment, only small portion of patients have experienced long-term survival. The objective of this study was to describe the clinical characteristics and therapeutic features, and to analyze the prognosis in small cell lung cancer. Methods: We analyzed retrospectively 151 evaluable patients with histologically confirmed small cell lung cancer from August 1989 to June 1995 at our institution. Of 151 patients, 3 had surgery and chemotherapy, 59 had chemotherapy and chest irradiation, and 89 had chemotherapy only. Results: Most patients(82.1%) were men, and the median age was 62 years. Of all patients, 49% had performance status of 0.1 and 59.6% had limited disease. The overall response rate was 67.8% : complete response 23.8%, partial response 44.4%. Complete responses were documented in all of three patients who had surgery and chemotherapy, 49.2% of those who had chemotherapy and radiotherapy, and 4.5% of those who had chemotherapy only. The median follow-up duration was 309 days. The median progression-free survival and overall survival were 256 days and 354 days, respectively: patients who had surgery and chemotherapy were 1631 days and 1631 days, those who had chemotherapy and radiotherapy were 344 days and 450 days, and those who had chemotherapy only were 186 days and 278 days, respectively; complete responders were 580 days and 710 days, partial responders were 231 days and 364 days, non-responders were 132 days and 151 days, respectively. Of 151 patients, 11.3% survived more than two years(long-term survival). Most long-term survivors had limited disease(82.4%) and good performance(76.5%). Long-term survival ocurred in two patients of those who had surgery and chemotherapy, 16.9% of those who had chemotherapy and radiotherapy, and 5.6% of those who had chemotherapy only. Most long-term survivors(70.6%) had complete response. Twenty of 36 complete responders and 8 of 17 long-term survivors had disease relapses or progressions. Patients with limited disease, those with good performance, and those with normal alkaline phosphatase had a significantly higher complete response rate and longer progression-free survival and overall survival than their counterparts. Of pretreatment characteristics, stage and performance status were correlated complete response and survival, independently. Complete response outcome was significant independent variable for survival. Conclusion: The disappointing results in this disease support the need for both new treatment strategies to improve complete response rate and to decrease relapse rate and large-scaled prospective studies to know natural history of long-term survivors.