Three-dimensional conformal radiotherapy or intensity-modulated radiotherapy combined with concurrent sequential chemotherapy for limited stage small cell lung cancer

OBJECTIVE: To evaluate the responses and acute toxicities and life quality of concurrent sequential radiochemotherapy with three-dimensional conformal radiotherapy or intensity-modulated radiotherapy for limited stage small cell lung cancer(LS-SCLC).METHODS: Totally 45 patients with LS-SCLC were randomized into concurrent group(group A,23 patients) and sequential group(group B,22 patients).All patients in these two groups received 3D-CRT and IMRT(1.8-2.0 Gy/f,5 times every week,totally,50.4～62.0 Gy in 28～31 F) and 4～6 cycles of sequential chemotherapy by EP regimen.The radiotherapy targets were the primary tumor and the involved lymph nodes.3D-CRT and IMRT were started in the first cycle of chemotherapy in group A.Patients in group B were treated with radiation after 4～6 cycles of chemotherapy.RESULTS: The overall response rate of group A and group B was 95% and 86% for the primary tumor.The 12-and 18-month overall survival rate were 84%,69% and 76%,34%.Grade Ⅰ or Ⅱ acute radiation esophagitis and pneumonitis was observed in 78% and 86% of patients in group A compared with 73% and 81% in group B.Grade Ⅲ-Ⅳ acute hematopoietic toxicity was observed in 8% of patients in group A and 9% in group B.Life quality was no statistically significant differences between the two groups.CONCLUSION: 3D-CRT and IMRT with current sequential chemotherapy is effective for LS-SCLC with the side effects being tolerable and quality of life being not falling.