Intensity modulated radiation therapy combined with chemotherapy for medium and late stage non-small cell lung cancer

OBJECTIVE:To evaluate the effect of intensity modulated radiation therapy (IMRT) for medium and late stage non-small cell lung cancer. METHODS: Seventy-two patients with medium and late stage non-small-cell lung cancer were grouped. Group A consisted of 30 patients, receiving conventional radiotherapy plus chemotherapy. Group B consisted of 30 patients, treated with three-dimensional conformal radiotherapy (3-DCRT) plus chemotherapy. Twelve patients were involved in Group C, and IMRT in conjunction with chemotherapy was performed in this group. All these patients received one cycle chemotherapy of Navetbine+Cisplatin (NP) before radiotherapy and other three to five cycles after radiotherapy. RESULTS: The overall response rate (CR+PR) was 43.3% in Group A, and 70.0%, 83.3% in Group B and C respectively. In Group A there was a significant difference (P0.05) compared with Group B. The same result could be seen between Group A and C. In terms of one-year survival rate, it was 40% in Group A, and 66.7%, 100.0% in Group B and C respectively. The one-year survival rate in combination with Group B and C was statistically different from that in Group A, P=0.03. Myelosuppression in the three groups was similar. Esophageal toxicity was also observed. There was no statistical difference among the three Groups, P=0.16. Acute radiation-induced pulmonitis was 56.7% in Group A, 33.3% in Group B and 15.7% in Group C. Significant difference was found between Group A and Group C, P=0.031. CONCLUSIONS: 3-DCRT or IMRT combined with chemotherapy in the treatment of non-small cell lung cancer has the feature of good efficacy, less side effects and well-tolerated approach, in contrast with the conventional radiotherapy plus chemotherapy. IMRT can increase not only the one-year survival rate but radiation dose for target, without enhancing the side effect of radiotherapy.