COMPARISON BETWEEN CONCOMITANT CHEMO-RADIOTHERAPY WITH CISPLATIN VERSUS INDUCTION CHEMOTHERAPY FOLLOWED BY CONCOMITANT CHEMORADIOTHERAPY WITH CISPLATIN AND ETOPOSIDE REGIMEN IN CASES OF LOCALLY ADVANCED NON –SMALL CELL LUNG CANCER

S. Lotfy, Nashaat; F. Mostafa, Mohamed; A. Abd El Moneim, Nadia; H. Mohamed, Radwa

doi:10.21608/jmalexu.2020.145856

COMPARISON BETWEEN CONCOMITANT CHEMO-RADIOTHERAPY WITH CISPLATIN VERSUS INDUCTION CHEMOTHERAPY FOLLOWED BY CONCOMITANT CHEMORADIOTHERAPY WITH CISPLATIN AND ETOPOSIDE REGIMEN IN CASES OF LOCALLY ADVANCED NON –SMALL CELL LUNG CANCER

Document Type : Original Article

Authors

¹ Department of Clinical Oncology and Nuclear Medicine, Faculty Of Medicine ,Alexandria University, Egypt

² Department of Cancer Management and Research,Medical Research Institute ,Alexandria University. Egypt

10.21608/jmalexu.2020.145856

Abstract

ABSTRACT Background:This study was designed to compare between patients treated with concurrent chemo-radiotherapy with single agent cisplatin and those treated with induction chemotherapy with cisplatin –etoposide regimen followed by concomitant chemo-radiotherapy with cisplatin and etoposide combined regimen. We randomly assigned 40 patients with biopsy proven locally advanced irresectable non metastatic non small cell lung cancer to one of two treatment. Concurrent conformal chemo-radiotherapy at a dose of 60Gy in 6 weeks with single agent Cisplatin 50 mg/m2 on the first day of each treatment weekly or patient underwent Induction chemotherapy with two cycles of cisplatin [25 mg/m2 on days 1-3] and etoposide [100 mg/m2 on days 1-3] regimen with an interval of 21 days followed by conformal concomitant thoracic irradiation [60 Gy /6weeks] with two more cycles of the same chemotherapy regimen Results showed that response was significantly improved in the induction group with cisplatin and etoposide as compared with the concurrent chemo-radiotherapy group with single agent cisplatin [P = 0. 014 ],with median follow up of 18 months,the survival was numerically better in the induction group although it did not reach level of significance,there was significant improvement in progression free survival in the induction arm,mean progression free survival was 11.01 in the induction arm versus 8.06 in the concomitant chemoradiotheapy arm [p= 0. 016] Conclusion: In locally advanced NSCLC,the induction chemotherapy with cisplatin and etoposide followed by concomitant chemoradiotherapy with the same agents gets significant better overall response and disease free survival than concomitant chemoradirtherapy with single agent cisplatin.