[Analysis of preoperative concurrent chemoradiotherapy in the treatment of patients with superior sulcus tumor of the lung]

Abstract

Background: Recently chemoradiotherapy becomes a standard treatment for un- resectable advanced non-small cell lung cancer (NSCLC) instead of radiotherapy alone. Superior sulcus tumor of the lung (Pancoast tumor) is a clinical subtype of NSCLC. The aim of this study is to compare the clinical effects and toxicities of preoperative concurrent chemoradiotherapy with radiotherapy alone in patients with superior sulcus tumors.

Methods: Fifty-six patients with superior sulcus tumors were divided randomly into two groups: twenty-six patients received concurrent chemoradiotherapy (chemoradiotherapy group), the other thirty patients received only radiotherapy (radiotherapy group). For both groups, the same radiation technic was given with the convention fraction. The total dose was 45Gy/25 fraction/5 weeks. For the chemoradiotherapy group, the patients were also given with concurrent chemotherapy (navelbine 15-18mg/m² on the 1st and 8th day, cisplatin 60mg/m² on the 1st day).

Results: The rate of complete resection in the chemoradiotherapy group was significantly higher than that in the radiotherapy group (92.3% vs 80.0%, P < 0.05); The complete pathological response rate and 2-year survival rate in the chemoradiotherapy group were significantly higher than those in the radiotherapy group (P < 0.01, P < 0.01). The incidences of grade III-IV radiation esophagitis and leukopenia in the chemoradiotherapy group were significantly higher than those in the radiotherapy group (23.1% and 23.1% vs 6.7% and 0, P < 0.01, P < 0.01).

Conclusions: Preoperative concurrent chemoradiotherapy has the potential of improving the survival rate of superior sulcus tumors. It can also increase the acute toxic effect, but all patients can tolerate this treatment regimen, so it might be a new "standard treatment" for superior sulcus tumor of the lung.