Three dimensional comformal radiation for treatment of 32 patients with non-small cell lung cancer

Objective To evaluate the feasibility of d ose-escalation non-small-cell lung cancer(NSCLC) treatment using 3-dimensional c onformal radiotherapy and to assess the immediate responses and acute side-effec ts. Methods Thirty two patients with inoperable NSCLC wer e evaluated .Conventional irradiation technique was used until the tumor dose r eached 6MV-X 38~40Gy. Toppslan of Shanghai three dimensional treatment planning system(3D-TPS) was used to design the dose-escalation treatment plan and DVHs w as used to optimize it .The planning targe volum(PTV) encompassed 1~1.5cm outise the clinical target volume(CTV). The irradiation doses of dose-escalation treat ment plan ranged from 21~27Gy , and were delivered in daily fractions of 3~4 Gy, 5 days a week . WHO criteria and RTOG/EORTC grading scheme were used to assess the immediate responses and acute side-effects . Results All 32 patients completed the treatment successfully .The median radiation dose to the gross tumor volume(GTV) was 67Gy(64 ~70 Gy). The overall immediate respon se rate (CR+PR) was 71.0%(23/32)acute radiation esophagitis occurred in 29%(9/23 ) of patients .Acute radiation pneumonitis occurred in 21%(6/32)of patients with grade 1~2.The bone marrow toxicity occurred in16%( 6/32). Damage to the heart o ccurred in 12.0%(4/32) with grade 1~2 .Median follow-up was 14 months . Conclusion Dose-escalation in NSCLC treatment using 3-dimensional conformal radiotherapy has an encouraging immediate response rate with lower a cute complication. Later side-effects of irradiated and survival rate will be ob served.