الفهرس 
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Abstract
This study included diagnosed as unresectable stage III NSCLC according to AJCC and the international union against cancer IUAC.
All patients were treated as the following:
• The induction chemotherapy:
The patients will be treated with cisplation٨٠ mg/m٢ day ١, etaposide ١٥٠ mg/m٢ days ١،٢،٣ every ٢١ days for ٢ cycles.
• The concurrent chemoradiation:
The patients will be treated with chest irradiation to a total dose ٦٠ Gy/٦ weeks; ٥ days a week. Cisplation will be given weekly ٢٥ mg/m٢ with proper hydration.
Aim of this study is to evaluate the treatment outcome of locally advanced NSCLC using induction chemotherapy followed by concurrent chemoradiotherapy.
• The following results obtained:
In the present study response rates assessed at the end of treatment, non of the patients had complete response after concurrent chemotherapy. Partial response was achieved in ٥٢٫٥%, stable disease
Correlation between response and performance status showed that patients with ECOG<٢ showed significently better response rate (٦٠٪)better than those with ECOG =٢ (١٢٪) (P<٠٫٠٢٥).
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Summary
As regarding tumour caracteristics it was found that T١,T٢ showed better response rate (٥٢٫٥٪) where as T٣,T٤ showed no response rate (P<٠٫٠٢٢).comparing nodal involvement and partial response it was found that there is significant relation between nodal status and response (P<٠٫٠١٦)
In the present study patients with large cell carcinoma achieved higher response rate ( ) than patients with squamous cell carcinoma ( ) but does not reach level of significance. In comparing different pathological grading and response it was found that well differentiated tumours showed better response rate ( ) than poorly differentiated tumours ( ) but it does not reach level of significance .
As regarding early radiation reactions, oesophagitis it was noted that grade of oesophagitis related to volume irradiated ,in class I(V٦٠<٣٠٪) patients grade ١, ٢ observed in ٦ patients while in class II (V٦٠>٣٠٪) patients grades ١, ٢ observed in ٤ patients. There was significant relation between volume irradiated and oesophagitis.
Tae Kim et al studied dose volumetric parameters of acute oesophageal toxicity, they concluded that concurrent chemotherapy and V٦٠ associated with development of sever oeophageal toxicity.
Radiation induced pneumonitis grade ٢،٣was prevalent in V٢٠ class II, III patients than V٢٠ < ٣٠٪ (class I)with significant value (P٠٫٠١٦٩).
Mary Graham et al (٣٨٧) concluded from clinical dose volume histogram (DVH) analysis for pneumonitis after ٣D treatment for NSCLC, that the percent of the lung volume exceeding ٢٠ Gy (V٢٠ ) ,the effective
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Summary
volume (Veff) and the total mean lung dose (MLD) ,and the location of primary (upper versus lower lobes) to be statistically significant relative to development of grade ٢ pneumonitis .Multivariate analysis revealed V٢٠ to be the single dependent predictor of pneumonitis (Non-small Cell Lung Cancer Collaborative Group, ١٩٩٥ )
Total mean lung dose was found to have significant effect on development of acute radiation pneumonitis .For class I (<١٠Gy) no radiation pneumonitis developed. For class II grade ٢ pneumonitis was ( ) it was found that there was significant relation between radiation pneumonitis and total mean lung dose (P ٠٫٠٢٢)
Overall survival was calculated from the first day ot treatment. The patients were followed up to total period of ١٨ months. ١ year survival was ٥٥٪, ٢ patients died at the beginning of treatment one had poor performance status ,the other had febrile neutropenia by the end of the second cycle during induction chemotherapy.