Clinical analysis of three-dimensional conformal radiotherapy plus chemotherapy for locally advanced non-small cell lung cancer:study of 56 patients

Objective To analyze the efficacy,complications and prognostic factors of three-dimensional conformal radiotherapy(3 DCRT)for locally advanced non-small cell lung cancer(NSCLC).Methods 56 patients who were treated either by radiotherapy alone(14 patients)or radiotherapy plus chemotherapy(42 patients)from Jan.2005 to Feb.2008 were enrolled.The patient cohort consisted of 36 men and 20 women,median age 62,median total dose 60 Gy.Results The following-up rate was 96%.The number of patients completed follow-up were 14 and 10,respectively at 3-year and 5-year.The response rate of 3DCRT was 70%.with complete mmission 9%and partial remission 61%.The 1-、3-、and 5-.year survival rates were 62%、25% and 17%,respectively,and the median survival time(MST)was 20 months.By logrank test,clinical stage,KPS perfomance,tumor volume,radiation dose,treatment regimen and response to treatment showed statistically dramatic impact on overall survival.By Cox muhivariable regression,the independent adverse prognostic factors by both univariate analysis and multivariate analysis were clinical stage,treatment type,and response to treatment.Grade 2 acute radiation pneumonitis was observed in 1 patient and grade 3 in 1 patient.Late grade 2 lung injury developed in 1 patient,and grade 3 in 1 patient.Acute grade 1 radiation esophagitis were observed in 20 patients.and above Grade 2 in 5patients.Acute grade 1+2 hematologic toxicity developed in 15 patients,and above Grade 2 developed in 4 patients.Conclusions 3 DCRT was feasible in the treatment of locally advanced NSCLC with acceptable normal tissue toxicity.Relative early stage.radio-chemotherapy with total radiation dosage≥60 Gy and good immediate tumor response are favorable prognostic factors for overall survival. Key words: Cancer,non-small cell lung/radiochemotherapy;  Radiotherapy,three dimensional conformal;  Chemotherapy,sequential;  Chemotherapy,concurrent; Prognosis