Clinical outcome for lymphoepithelioma-like carcinoma of the lung cancer after chemoradiotherapy

Abstract

BACKGROUND: Lymphoepithelioma-like carcinoma (LELC) of the lung, an Epstein-Barr virus-associated undifferentiated carcinoma, is a rare form of non-small cell lung cancer. It predominantly affects young non-smoking Asians and is frequently believed to be resectable. However, there has only been limited experience with the use of palliative chemotherapy and radiotherapy in treating advanced LELC of the lung. STUDY OBJECTIVES: To evaluate the tumor response, time to progression and survival of patients with advanced LELC of the lung who received chemoradiotherapy. Design and patients: We prospectively recruited cases of LELC of the lung with a standard clinical protocol. Patients with confirmed advanced LELC of the lung were given chemoradiotherapy treatment. SETTING: A tertiary respiratory referral center. RESULTS: There were 10 patients (5 males, age 47 f 9.8 years, median follow-up 22 months) with advanced LELC of the lung (1, 4, and 5 patients at TNM stage IIIA, 1118, and IV) who received systemic chemotherapy and radiotherapy. The primary chemotherapy regimen comprised of 5- fluorouracil/leucovorin/cisplatin (FLP). The response rates to FLP were 60% partial response, 10% stable disease, and 30% progressive disease. Eight patients were given local radiotherapy. Five patients received salvage chemotherapy when disease progressed after primary chemotherapy. The overall median survival was 23.4 & 4.7 months. CONCLUSION: The encouraging response to combination chemotherapy (FLP) supports its use, along with radiotherapy, in unresectable LELC of the lung.