Three-dimensional conformal hypofractionated high-dose radiotherapy combined with chemotherapy for non-small-cell lung cancer

Objective To evaluate the effect of 3-dimensional conformal hypofractionated high-dose radiotherapy combined with chemotherapy on non-small-cell lung cancer (NSCLC). Methods Between July 1998 and October 1999, 43 NSCLC patients, of whom 30 with squamous carcinoma, 10 adenocarcinoma and 3 adenosquamous carcinoma were admitted into our department. They were first treated with chemotherapy by Gemcitabine (1000?mg/m 2, d1,d8) and Cisplatin (30?mg/m 2, d1～3) for 3 cycles, with one cycle lasting 21 days. Then, these patients received radiotherapy with 5-7 conformal fields if tumor≤7?cm and 3-4 conformal fields if tumor7?cm to a dose of 48-60?Gy in 8-10 fx over 21-24 days. Patients with positive supraclavicular lymph nodes received conventional fractionated radiotherapy with 12 MeV-E to a total dose of 66-70 ?Gy in 7 weeks. Therapeutic effect and survival rate were studied. Results Twelve patients achieved CR, 22 PR, 4 NR and 5 PD, with a total response rate of 79.1%(34/43). The 1-, 2- and 3-year survival rates were 75.2%, 53.2% and 35.4%. Conclusions Three-dimensional conformal hypofractionated high-dose radiotherapy combined with chemotherapy should be considered as an effective and feasible approach in the treatment of NSCLC patients. Long-term survival and possible specific injury await further study.