Research on the relationship of treatment toxicity with chemoradiotherapy order in limited-stage small cell lung cancer

Objective To explore the severity of toxicity reaction after treated by the sequential chemoradiotherapy, alternate chemoradiotherapy or concurrent chemoradiotherapy in limited-stage small cell lung cancer. Methods 63 cases of limited-stage small cell lung cancer were reviewed, according to the chemoradiotherapy order, all cases were divided into:sequential chemoradiotherapy 15 cases, alternate chemoradiotherapy 25 cases, concurrent chemoradiotherapy 23 cases. The correlation of the factors(leukocypenia, gastrointestinal reaction, pneumonia, esophagitis)with different treatment groups after treated in 2 months,4 months,6 months were analyzed. Results Three groups of all the factors treated in 2 months had no significant change(χ2=0.275,0.051,0.513,1.215,0.051,0.231,all P>0.05).In 4 months the cases of sequential chemoradiotherapy>or=2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 33.3%,33.3%,0.0%,0.0%;In the cases of alternate chemoradiotherapy>or=2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 16.0%,4.0%,16.0%,0.0%;In the cases of concurrent chemoradiotherapy>or=2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 52.2%,34.8%,34.8%,4.3%;>or=2 myelosuppression,each level gastrointestinal reaction and the pneumonia of the three groups treated were statistically significant(χ2=7.054,9.702,7.947,6.145,7.373,all P or=2 myelosuppression,the gastrointestinal reaction, the pneumonia and the esophagitis were 26.7%,13.3%,13.3%,0.0%;In the cases of alternate chemoradiotherapy>or=2 myelosuppression, the gastrointestinal reaction,the pneumonia and the esophagitis were 40.0%,56.0%,12.0%,0.0%;In the cases of concurrent chemoradiotherapy>or=2 myelosuppression,the gastrointestinal reaction,the pneumonia and the esophagitis were 69.6%,65.2%,43.5%,0.0%;each level myelosuppression,>or=2 gastrointestinal reaction and the pneumonia of the three groups treated were statistically significant(χ2 =6.174,7.663,10.544,6.286,all P<0.05). Conclusion Leukopenia and gastrointestinal reaction are closely related with chemotherapy, chemoradiotherapy results in the worsen of myelosuppression. Pneumonia and esophagitis are closely related with chemotherapy, chemoradiotherapy result in the worsen of radiation pneumonitis. Key words: Lung neoplasms; Radiation therapy; Chemotherapy; Toxicity reaction