Abstract:

Aim: To evaluate the toxicity, tumor response and suruiual rates of two different radiotherapy schemes (RT) following 2 cycles of cisplatin (CP) and vinorelbine (VN) chemotherapy and to determine the potentiai prognostic factors of survival. Methods: Eighty nine cases with proven stage III-B non-small-cell lung cancer were given 2 cycles of CP (80 mg/m2/Dı)-VN (30 mg/m2/D1,D8) every 3 weeks. Then 49 patients were treated with 66 Gy conventional external radiotherapy (CRT) and 32 with 69.6 Gy hyperfractionated external radiotherapy (HRT). SPSS 9.0 Computer programming was used for statistically analysis. OveralI survival were estimated using Kaplan- Meier method, Uni-variate analysis was done using log-rank method and multi-variate analysis were done using cox proportional hazard method. Results: Median age was 60 (40-70) and 95% of the patients were men. While objective response rate was 48,1% after neo-adjuvant chemotherapy, it was found 75.3% for the total number of the patients. Statistically significant difference was found between the two groups of radiotherapy (p=0.837). Median survival time of the whole group was 14.8 months and 5 year survival rate was 15.3%. Median survival time of the CRT and the HRT groups were 14.8 months and 13.4 months, and the 5 year survival rates were 11.3%) and 21.4%orespectively, with no statistically significant difference between the tuuo groups (p=0.456). The patient characteristics of each radiotherapy group were similar. The rates of grade 3-4 neutropenia, febrile neutropenia, grade 3-4 esophagitis and grade 3-4 pulmonary toxicity were 44.1%, 5.3%, 6.1% and 9.8% respectively. No statistically significant differences were detected among two radiotherapy groups. In uni-variate analyses the prognostic factors for survival were performance status, weight loss, response to neo-adjuvant chemotherapy and to radiotherapy; in multi-variate analyses the prognostic factors were nodal stage, performance status, weight loss, response to neo-adjuvant chemotherapy and to radiotherapy. Conclusions: Radiotherapy- whether given as a conventional or as a hyperfractionated scheme following 2 courses of CP-VN did not differ regarding toxicity, tolerance, response rates and survival.

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