HYPERFRACTIONATED RADIOTHERAPY SIMULTANEOUS WITH CHEMOTHERAPY IN INOPERABLE NON-SMALL CELL LUNG CANCER

Between March 1992-February 1993 hyperfractionated radiotherapy (HRT) (1.2 Gy/fraction, twice a day, total doses of 69.6 Gy) simultaneous with cisplatin (70 mg/m2, 3rd and 23rd days of HRT) and etoposide (70 mg/m2, 1-3rd and 20-23rd days of HRT) was applied to 27 inoperable non-small cell lung cancer (NSCLC) cases. Their Karnofsky performance status were 70-90%, mean age was 52 (36-63). Two cases were stage II, 8 were stage IIIA and 17 were stage NIB. No severe life threatening grade IV acute toxicity findings were observed. The treatment was well tolerated without any significant decrease in the patients performance levels. Tumor responses were as follows: complete response in 6 cases (23%), partial response in 19 cases (70%), stable disease in 2 (7%). When complete response rates were compared according to stage, histologic type, age groups and weight loss, no statistically significant difference was found. Median overall and disease free survival time were 13 months (95% Cl 10-16 months) and 9 months (95% Cl, 7-11 months) respectively. Twelve and 24-month overall and disease free survival rates were 51.8%, 29.6% and 34.8%, 23.2% respectively. No statistically significant difference was found in overall survival rates of epidermoid and nonepidermoid types (P=0.196), while the difference in disease free survival was statistically significant (P=0.035). The acute and late complications of this HRT and simultaneous chemotherapy protocole was tolerable and the survival rates were evaluated as promising.