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학술저널
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Kim, Hwan-Ik (Department of Radiation Oncology, Ajou University School of Medicine) Noh, O Kyu (Department of Radiation Oncology, Ajou University School of Medicine) Oh, Young-Taek (Department of Radiation Oncology, Ajou University School of Medicine) Chun, Mison (Department of Radiation Oncology, Ajou University School of Medicine) Kim, Sang-Won (Department of Radiation Oncology, Ajou University School of Medicine) Cho, Oyeon (Department of Radiation Oncology, Ajou University School of Medicine) Heo, Jaesung (Department of Radiation Oncology, Ajou University School of Medicine)
저널정보
대한방사선종양학회 Radiation oncology journal : ROJ Radiation oncology journal : ROJ 제34권 제3호
발행연도
2016.1
수록면
202 - 208 (7page)

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Purpose: Our institution has implemented two different adjuvant protocols in treating patients with non-small cell lung cancer (NSCLC): chemotherapy followed by concurrent chemoradiotherapy (CT-CCRT) and sequential postoperative radiotherapy (PORT) followed by postoperative chemotherapy (POCT). We aimed to compare the clinical outcomes between the two adjuvant protocols. Materials and Methods: From March 1997 to October 2012, 68 patients were treated with CT-CCRT (n = 25) and sequential PORT followed by POCT (RT-CT; n = 43). The CT-CCRT protocol consisted of 2 cycles of cisplatin-based POCT followed by PORT concurrently with 2 cycles of POCT. The RT-CT protocol consisted of PORT followed by 4 cycles of cisplatin-based POCT. PORT was administered using conventional fractionation with a dose of 50.4-60 Gy. We compared the outcomes between the two adjuvant protocols and analyzed the clinical factors affecting survivals. Results: Median follow-up time was 43.9 months (range, 3.2 to 74.0 months), and the 5-year overall survival (OS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 53.9%, 68.2%, and 51.0%, respectively. There were no significant differences in OS (p = 0.074), LRFS (p = 0.094), and DMFS (p = 0.490) between the two protocols. In multivariable analyses, adjuvant protocol remained as a significant prognostic factor for LRFS, favouring CT-CCRT (hazard ratio [HR] = 3.506, p = 0.046) over RT-CT, not for OS (HR = 0.647, p = 0.229). Conclusion: CT-CCRT protocol increased LRFS more than RT-CT protocol in patients with completely resected NSCLC, but not in OS. Further studies are warranted to evaluate the benefit of CCRT strategy compared with sequential strategy.

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