Outcome of patients with locally advanced Non-small cell lung cancer treated with sequential chemotherapy and radiotherapy in Duhok/ Iraq
DOI:
https://doi.org/10.56056/amj.2019.96Keywords:
Chemoradiation, Chemotherapy, Non-small cell lung cancer, RadiotherapyAbstract
Background and objectives: About one-third of non-small cell lung cancer patients present with locally advanced unresectable disease. The overall survival and progression-free survival evaluated of patients with stage IIIA and B non-small cell lung cancer treated with sequential chemotherapy and radiotherapy. The aim of the study was to evaluate the efficacy of sequential chemotherapy and radiotherapy in advance non-operable non-small cell lung cancer.
Methods: This retrospective study included 45 patients with advanced non-small cell lung cancer diagnosed between May 2014 and May 2017 treated with sequential chemotherapy and radiotherapy. All patients were treated at Azadi Cancer Centre, Azadi Teaching Hospital, Duhok with at least 4 cycles of chemotherapy then sent to radiotherapy in other centre to complete their planned treatment protocol.
Results: This study showed that squamous cell cancer was the most common histological subtype. The overall survival of patients treated with sequential chemotherapy and radiotherapy was 19.6 months (95% confidence interval 13.5–27.8, 95% confidence interval). The median progression-free survival time was 11.1 months (95% confidence interval; 8.6–13.7 months). Over all chemotherapy and radiotherapy tolerated well in most of the patients with mild adverse effect.
Conclusions: Sequential chemotherapy and radiotherapy is a valid option of treatment in inoperable non-small cell lung cancer. This mainly helpful in area with limited resources for radiotherapy. These results provide hope and support of using sequential chemotherapy and radiotherapy in advanced stage lung cancer ineligible for surgery.
Downloads
References
Ferlay J, Soerjomataram I, Dikshit R et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. International journal of cancer. 2015;136(5): E359-86.
Othman RT, Abdulljabar R, Saeed A et al. Cancer Incidence Rates in the Kurdistan Region/Iraq from. Asian Pacific Journal of Cancer Prevention. 2011; 12:1261-4.
Khoshnaw N, Mohammed HA, Abdullah DA. Patterns of cancer in Kurdistan-results of eight years cancer registration in Sulaymaniyah Province-Kurdistan-Iraq. Asian Pac J Cancer Prev. 2015;16(18):8525- 31.
Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA: a cancer journal for clinicians. 2017;67(1):7-30.
Walder D, O’Brien M. Looking back and to the future: Are we improving ‘cure’ in non-small cell lung cancer? European journal of cancer (Oxford, England: 1990). 2017; 75:192-4.
Van der Meer FS, Schramel FM, Van Vulpen M, El Sharouni SY. Feasi- bility of Concomitant Chemoradiotherapy in Daily Practice for Patients with NSCLC Stage III. Anticancer research. 2016;36(9):4673-6.
Walraven I, Damhuis R, Ten Berge M et al. Treatment Variation of Sequential versus Concurrent Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer Patients in the Netherlands and Belgium. Clinical Oncology. 2017;29(11): e177-e85.
Goldstraw P, Crowley J, Chansky K et al. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer. 2007;2(8):706-14.
Dillman RO, Seagren SL, Propert KJ et al. A randomized trial of induction chemotherapy plus high-dose radiation versus radiation alone in stage III non-small-cell lung cancer. The New England Journal of medicine. 1990;323(14):940-5.
Le Chevalier T, Arriagada R, Quoix E et al. Radiotherapy alone versus combined chemotherapy and radiotherapy in nonresectable non-small-cell lung cancer: first analysis of a randomized trial in 353 patients. Journal of the National Cancer Institute. 1991;83(6):417-23.
Blackstock AW, Govindan R. Definitive chemoradiation for the treatment of locally advanced non-small-cell lung cancer. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2007;25(26):4146-52.
Othman RT, Abdulljabar R, Saeed A et al. Cancer incidence rates in the Kurdistan region/Iraq from 2007-2009. Asian Pacific journal of cancer prevention: APJCP. 2011;12(5):1261-4.
Al-Rahim YA. Lung Cancer in a sample of Iraqi patients. Al-Kindy College Medical Journal. 2007; 4:53-61.
Hussein ZS, Karadakhy KA. Radiological and clinicopathological findings in large case series study of lung cancer in Erbil City/Iraq. Medical Journal of Babylon. 2018;15(4):391-5.
Almasi Z, Salehiniya H, Amoori N, Enayatrad M. Epidemiology characteristics and trends of lung cancer incidence in Iran. Asian Pac J Cancer Prev. 2016;17(2):557-62.
Al-Hashimi M, Wang XJ. Trend analysis of lung cancer incidence rates in Ninawa province, Iraq, from 2000 to 2010—decrease and re- cent stability. Asian Pac J Cancer Prev. 2014;15(1):385-90.
Pan C-C, Kung P-T, Wang Y-H, Chang Y-C, Wang S-T, Tsai W-C. Effects of multidisciplinary team care on the survival of patients with different stages of non-small cell lung cancer: a national cohort study. PloS one. 2015;10(5): e0126547.
Curran Jr WJ, Paulus R, Langer CJ et al. Sequential vs concurrent chemoradiation for stage III non–small cell lung cancer: randomized Phase III trial RTOG 9410. Journal of the National Cancer Institute. 2011;103(19):1452-60.
Aupérin A, Le Péchoux C, Rolland E et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol.2010; 1;28(13):2181-90.
Driessen EJ, Bootsma GP, Hendriks LE et al. Stage III Non-Small Cell Lung Cancer in the elderly: Patient characteristics predictive for tolerance and survival of chemoradiation in daily clinical practice. Radiotherapy and Oncology. 2016;121(1):26-31.
Miller ED, Fisher JL, Haglund KE et al. The addition of chemotherapy to radiation therapy improves survival in elderly patients with stage III non-small cell lung cancer. J Thorac Oncol. 2018;13(3):426-35.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Ramadhan Tayeb Othman
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in AMJ (The Scientific Journal of Kurdistan Higher Council of Medical Specialties )is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0)