适形放疗同步吉西他滨治疗晚期胰腺癌疗效分析

 目的 探讨采用适形放疗同步吉西他滨治疗不可切除胰腺癌的疗效及安全性.方法 22例不可手术切除的胰腺癌患者接受同步放化疗,均采用三维适形放疗,靶区DT:36～58 Gy/ 9～25 F;同步化疗采用单药吉西他滨每周600～750 mg/m2,静滴,1次/周,共4～7周;治疗期间观察有效率、中位生存期、1年生存率及不良反应.结果 CR 3例(13.6%),PR 4例(18.2%),SD 10例(45.5%);有效率(CR+PR)31.8%,疾病控制率77.3%;1年生存率为31.8%;中位生存期为8.1个月.治疗过程中有7例出现Ⅲ-Ⅳ毒性反应,其中5例表现为血小板下降,对症治疗可恢复,无治疗相关死亡事件发生.结论 三维适形放疗同步单药吉西他滨对不可切除胰腺癌的治疗安全、有效.     

吉西他滨诱导化疗后放疗同步联合卡培他滨治疗局部进展期胰腺癌的临床疗效

目的 评价吉西他滨诱导化疗后放疗同步联合卡培他滨治疗局部进展期胰腺癌（LAPC）的安全性及疗效。方法 对42例局部进展期胰腺癌用吉西他滨诱导化疗7周,每周1次,每次1000mg/m²,休息1周后开始放疗同步联合卡培他滨化疗,卡培他滨剂量为825mg/m²,2次/d,5d/周;放疗采用常规分割1.8~2.0Gy/次,中位照射剂量54Gy（34~64Gy）。结果 临床受益反应（CBR）20例,占47.6%;近期疗效：完全缓解（CR）2例,部分缓解（PR）8例,稳定（SD）27例,进展（PD）5例,中位生存时间10.1个月（4~36个月）;1年、2年生存率分别是38.2%和18.2%。骨髓抑制1~2级20例,3级以上5例;胃肠道不良反应1~2级22例,3级以上4例。结论 吉西他滨诱导化疗后再放化联合治疗局部进展期胰腺癌疗效较好,不良反应可耐受。     

肝门区胆管癌根治术后三维适形放疗效果观察

目的：探讨IVa期肝门胆管癌根治术后切缘镜下阳性者行三维适形放疗（3DCRT）的初步效果。方法：对IVa期肝门肝管癌43例实施根治性手术,术后病理均为腺癌,切缘镜下阳性者29例,其中11例在根治术后进行三维适形放疗（综合组）,余18例根治术后未行其他治疗（对照组）。术后第1天开始计算生存时间,采用Kap-lan-Meier法分析两组生存状况。结果：对照组1例失访,余均获随访,其中术后15天因肝衰竭和多脏器衰竭死亡1例。综合组和对照组3年远处转移率分别为54.5%和43.75%,3年生存率分别为54.5%和25.0%,综合组和对照组中位生存期分别为47.2个月和27.7个月。结论：三维适形放疗能有效延长IVa期肝门肝管癌根治术后患者的生存期,但对控制肿瘤远处转移无效。     

三维适形放疗联合吉西他滨治疗胰腺癌疗效观察

目的：观察三维适形放疗联合吉西他滨治疗局部晚期胰腺癌的疗效。方法：局部晚期胰腺癌42例随机分为观察组和对照组各21例。观察组采用三维适形放疗,同时给予吉西他滨同步化疗,放疗开始的第1、8、29、36天,给予吉西他滨1000mg／群;对照组采用单纯放疗。结果：两组总有效率、1年生存率比较,差异不显著（P〉0．05）;2年生存率及中位生存期比较,差异显著（P〈0．05）;观察组CBR指数优于对照组;两组疼痛评分比较,差异显著（P〈0．05）;观察组KPS评分升高、体重增加等与对照组比较,差异不显著（P〉0．05）。结论：三维适型放疗联合吉西他滨治疗局部晚期胰腺癌,能控制肿瘤生长,缓解疼痛,改善患者生活质量,延长生存期。     

放化疗联合靶向治疗晚期胆道恶性肿瘤的临床观察

目的探讨放化疗联合靶向治疗不可切除胆道恶性肿瘤患者的临床价值和安全性。方法2007年1月—2010年12月,我科收治不可切除胆道恶性肿瘤患者12例,其中肝内胆管癌8例、下端胆管癌1例和胆囊癌3例。所有患者予伽马刀放疗（总量42—50Gy）;ZELOX方案化疗,21d为1个周期,最多6个周期（奥沙利铂130mg／m2,dl;卡培他滨2000mg／m2,d1～14）;每个化疗周期给予Bevaci-zumab（5mg／kg）。观察放化疗联合靶向治疗不可切除胆道恶性肿瘤的临床疗效、生存时间及毒副作用。结果12例患者均接受了放化疗和靶向治疗,中位化疗周期数4．5个,中位放疗剂量46Gy。随访患者全部死亡,中位随访时间为18．2个月,中位TTP7．25个月,中位生存期为14．6个月,其中CR0例,PR6例（50％）,SD4例（33．3％）,临床获益率83,3％,1年和2年生存率为58．3％和O％。放化疗联合靶向治疗不可切除胆道恶性肿瘤毒副作用轻微,多为1～2度,无患者因不良反应而中断治疗。结论放化疗联合靶向治疗不可切除胆道恶性肿瘤有一定的疗效,耐受性好。     

局部晚期胰腺癌调强放疗与三维适形放疗剂量学比较及临床疗效分析

目的 比较局部晚期胰腺癌放疗中三维适形放疗(3 D-CRT)与调强放疗(IMRT)技术的剂量学差异,观察IMRT联合吉西他滨局部化疗的临床疗效.方法 选择10例局部晚期胰腺癌患者的CT定位图像,分别设计3D-CRT和IMRT计划,利用剂量体积直方图(DVH)评价2种治疗计划的剂量.回顾性收集2008年5月至2010年5月符合入组标准的25例接受IMRT联合吉西他滨局部介入治疗的局部晚期胰腺癌患者(联合治疗组),选择同时期入院的仅接受吉西他滨局部介入治疗的25例晚期胰腺癌患者(单化组)做对比研究,比较2组的临床疗效及不良反应.结果 IMRT计划中十二指肠、肝脏、胃、双肾、小肠的平均剂量及高剂量区照射体积明显低于3D-CRT计划.联合治疗组与单化组1、2年生存率分别为60％、28％和36％、12％,中位生存期分别为15个月和10个月(x2 =4.16,P＜0.05),有效率分别为64％和32％(x2 =5.13,P＜0.05).联合治疗组上消化道反应发生率高于单化组(Z=-2.35,P＜0.05),而骨髓抑制、肝肾功能损害情况差异无统计学意义.结论 与三维适形放疗相比,调强放疗在保证靶区高剂量的情况下降低危及器官的剂量,联合吉西他滨局部化疗可显著提高局部晚期胰腺癌患者的生存率,延长的中位生存时间,且不良反应轻微.     

三维适形放疗联合同步化疗治疗局部复发鼻咽癌的疗效分析

目的探讨三维适形放疗(3-DCRT)联合同步化疗治疗局部复发鼻咽癌的临床疗效。方法局部复发鼻咽癌患者36例采用3-DCRT治疗技术(总剂量DT:60⁷0 Gy/3070 Gy/30³5次,2 Gy/次,5次/周,参考剂量曲线选定为90%),同步予顺铂+5-氟尿嘧啶方案化疗,观察其临床疗效和毒副作用。结果治疗后135次,2 Gy/次,5次/周,参考剂量曲线选定为90%),同步予顺铂+5-氟尿嘧啶方案化疗,观察其临床疗效和毒副作用。结果治疗后1³个月内复查增强CT或MRI,获CR 15例(41.7%),PR 18例(50.0%),NC 2例(5.6%),PD 1例(2.7%),总有效率PR(CR+PR)为33例(91.7%)。1、2、3年生存率分别为95.1%、83.1%、57.5%。放射损伤包括听力丧失2例(5.6%)、张口困难10例(27.8%)、脑神经损伤6例(16.7%)。结论三维适形放疗联合同步化疗治疗鼻咽癌放疗后局部复发患者具有较高的近期疗效,毒副作用可耐受,放射损伤比例低,是一种可行、有效的方法。     

容积旋转调强放疗联合化疗治疗肛管鳞癌的疗效分析

目的 探讨调强放疗时代,肛管鳞癌同步放化疗的疗效及影响因素。方法 收集本院2011年以来接受根治性放疗的肛管鳞癌患者19例,回顾性分析该组患者的生存情况及其影响因素。结果 中位随访时间31个月,3年无局部复发生存和总生存分别为88.1%和91.7%。放化疗期间3级不良反应主要表现为白细胞减低（15.8%）、血小板减低（10.5%）、腹泻（15.8%）、皮肤反应（31.6%）。与历史数据对比,容积旋转调强放疗在肛管鳞癌的治疗中疗效和不良反应方面优于常规放疗。单因素分析显示,对比含5-FU的同步化疗方案,应用含卡培他滨的同步化疗可能是控制肿瘤进展的有利因素（P<0.05）。结论 调强技术放疗治疗肛管鳞癌在疗效和正常组织保护方面可能更有优势,同步化疗采用含卡培他滨的双药方案可能是降低肿瘤进展的有利因素。     

卡培他滨或5-Fu/亚叶酸联合奥沙利铂治疗进展期大肠癌的疗效与安全性分析

目的：比较卡培他滨（希罗达）或5-Fu／亚叶酸双周疗法联合国产奥沙利铂治疗进展期大肠癌的客观疗效及不良反应。方法：入选的60例进展期大肠癌患者分为两组，一组为5-Fu／亚叶酸双周疗法联合奥沙利铂，称5-Fu持续滴注组，共32例。另一组为卡培他滨联合奥沙利铂，称卡培他滨组，共28例。5-Fu持续滴注组平均化疗2．7周期，卡培他滨组平均化疗2．8周期。结果：5-Fu持续滴注组：完全缓解（CR）2例，部分缓解（PR）18例，稳定（NC）7例，进展（PD）5例，总有效率为62．5％。卡培他滨组：完全缓解（CR）2例，部分缓解（PR）16例，稳定（NC）4例，进展（PD）4例，总有效率为64．3％。两组均无治疗相关死亡，5-Fu持续滴注组主要毒副反应有口腔溃烂、腹泻、静脉炎、感觉神经毒性等，大部分为Ⅱ、Ⅲ度，上述不良反应发生率明显高于卡培他滨组（P〈0．01）。卡培他滨组较明显的毒副反应为恶心、呕吐、白细胞下降等，多为Ⅰ、Ⅱ度。结论：卡培他滨或5-Fu／亚叶酸双周疗法联合国产奥沙利铂治疗晚期大肠癌疗效均较好，但卡培他滨组临床应用方便、安全，毒副反应轻，患者的化疗依从性更好，是治疗晚期大肠癌较为理想的联合化疗方案。     

常规分割三维适形放疗对不可切除的原发性肝细胞癌的疗效分析

目的 探讨常规分割三维适形放疗对不可切除的原发性肝细胞癌的疗效.方法 用8MVX射线对52例不可切除的原发性肝细胞癌患者进行三维适形放疗,单次剂量2 Gy,每周5次,3.6～5.6周,总剂量36 ～ 66 Gy.CT扫描肿瘤最大直径、评价疗效、记录生存期及评估不良反应.结果 52例不可切除的原发性肝细胞癌患者中,完全缓解2例,部分缓解34例,总有效率为69.2％;放射性肝病发生率为1.92％.50 Gy以上和50 Gy以下剂量组缓解率分别为76.9％与46.2％(x2=10.72,P＜0.05).中位生存时间为10.5个月,1、2、3和4年生存率为57.7％、34.6％、23.1％和9.61％;未出现3或4级急性放射性损伤.结论 常规分割三维适形放疗治疗不可切除的肝细胞癌有效率高,不良反应轻.     

Chemoradiation in patients with unresectable extrahepatic and hilar cholangiocarcinoma or at high risk for disease recurrence after resection

BACKGROUND: The purpose of this work was to determine efficacy, toxicity, and patterns of recurrence after concurrent chemoradiation (CRT) in patients with extrahepatic bile duct cancer (EHBDC) and hilar cholangiocarcinoma (Klatskin tumours) in case of incomplete resection or unresectable disease. PATIENTS AND METHODS: From 2003-2010, 25?patients with nonmetastasized EHBDC and hilar cholangiocarcinoma were treated with radiotherapy and CRT at our institution in an postoperative setting (10?patients, 9?patients with R1 resections) or in case of unresectable disease (15?patients). Median age was 63?years (range 38-80?years) and there were 20?men and 5?women. Median applied dose was 45?Gy in both patient groups. RESULTS: Patients at high risk (9 times R1 resection, 1 pathologically confirmed lymphangiosis) for tumour recurrence after curative surgery had a median time to disease progression of 8.7?months and an estimated mean overall survival of 23.2?months (6 of 10?patients are still under observation). Patients undergoing combined chemoradiation in case of unresectable primary tumours are still having a poor prognosis with a progression-free survival of 7.1?months and a median overall survival of 12.0?months. The main site of progression was systemic (liver, peritoneum) in both patient groups. CONCLUSION: Chemoradiation with gemcitabine is safe and can be applied safely in either patients with EHBDC or Klatskin tumours at high risk for tumour recurrence after resection and patients with unresectable tumours. Escalation of systemic and local treatment should be investigated in future clinical trials.     

经皮肝穿胆管内金属支架置入联合伽玛刀立体定向放射治疗肝门部胆管癌

目的探讨经皮肝穿胆管内金属支架置入联合伽玛刀立体定向放射治疗肝门部胆管癌的疗效及安全性。方法 2005年10月—2007年1月对不愿意手术或不能手术治疗的21例肝门部胆管癌患者,给予经皮肝穿胆管内金属支架置入联合伽玛刀立体定向放射治疗。肿瘤边缘剂量4～8Gy/次,隔日1次,总剂量为40～60 Gy,10～20 d完成。结果患者行经皮肝穿胆管内支架置入术后,血总胆红素及直接胆红素水平均有显著下降。治疗后1~3月复查,1例出现再梗阻,其余血胆红素水平基本上接近正常。肿瘤病灶CR 2例,PR 14例,PD 1例,SD 3例,总有效率(CR+PR)为80%。胆道支架植入术中及术后,出现血压下降4例,放疗不良反应以消化道反应多见,均为I~II度。患者中位生存期为14.5月,1、2年生存率分别为47.6%、14.2%。结论经皮肝穿胆管内支架置入术联合伽玛刀立体定向放射治疗是肝门部胆管癌的一种有效方法,并发症及不良反应少。     

Concurrent Radiochemotherapy of Locally Recurrent or Advanced Sarcomas of the Uterus

BACKGROUND: Uterine sarcomas are rare tumors. Until now, no data on the treatment of recurrent or advanced uterine sarcomas using concurrent radiochemotherapy (RCT) has been available. PATIENTS AND METHODS: From 01/1997 to 03/2004, seven patients with locally recurrent (n = 6) or locally advanced uterine sarcomas (n = 1) received concurrent RCT after tumor surgery (R1/2 resection in 3/7 patients). A total radiation dose of 45 Gy was applied in single doses of 1.8 Gy using an external-beam technique; in addition, three to four intracavitary doses of 5 Gy were applied. Concurrent chemotherapy was generally administered as follows: 1.2 g/m(2) ifosfamide on days 1-5 and 29-33 in combination with 50 or 40 mg/m(2) adriamycin on days 2 and 30. 3/7 patients received further cycles of chemotherapy. The median follow- up was 35 months. RESULTS: All recurrences (before RCT) were localized either in the vagina or in or directly proximal to the vaginal stump. The main side effects of RCT were hemotoxicity (grade 3: n = 3/7; grade 4: n = 4/7; neutropenic fever n = 1/7) and diarrhea (grade 3: n = 5/7). At the median follow-up (35 months), 4/7 patients had recurrences (one local recurrence; one lymph node recurrence outside the irradiated field, two distant metastases). Local control in the irradiated field was 80% +/- 18% after 3 years. Disease-free survival calculated according to Kaplan-Meier was 57% +/- 19% after 3 years. Presently, 5/7 patients are still alive, corresponding to a 3-year survival rate of 83% +/- 15%. CONCLUSION: Concurrent RCT shows good local effectiveness with a good long-term survival. Further evaluation in phase II studies is recommended.     

Chemoradiation therapy for cervical cancer: toxicity of concurrent weekly cisplatin

Purpose To retrospectively evaluate the toxicity of concurrent weekly cisplatin and radiation therapy (RT) for locally advanced cervical cancer. Materials and Methods Between April 2001 and December 2004, 21 consecutive previously untreated patients with locally advanced cervical cancer were treated with concurrent chemoradiation therapy (CCRT) at the Tokushima University Hospital. Clinical stages were II: 5, III: 15, IVA: 1. External beam radiation therapy (EBRT) was delivered with 10 MV X-rays, 2 Gy fraction per day; total dose to the whole pelvis was 50 Gy. Iridium-192 high-doserate (HDR) intracavitary radiation therapy was performed with 10–30 Gy (median, 24 Gy) targeted at point A. Concurrent chemotherapy consisted of cisplatin, administered weekly at a dose of 40 mg/m² for patients who were younger than 65 years and 30 mg/m² for those 65 years or over. A maximum single dose of cisplatin, up to 70 mg/body, was administered in 5 cycles during EBRT. Results A total of 86 cycles of cisplatin were administered to the 21 patients, with a median of 4 cycles (range, 2–5). Severe hematological toxicity occurred in 18 patients (86%), including grade 3 in 17 patients (81%) and grade 4 in one patient (4.8%). Moderate or severe gastrointestinal toxicity occurred in 11 patients (52%), including grade 2 in 10 patients (48%) and grade 3 in one patient (4.8%). The grades of hematological toxicity were significantly greater in the 40 mg/m² group than in the 30 mg/m² group. All of the patients who were administered 40 mg/m² of cisplatin developed grade 3 or greater hematological toxicity, including one patient with grade 4 toxicity. In the 30 mg/m² group, 3 of 10 patients developed less than grade 3 toxicity, and all patients completed radiation therapy without interruption. Conclusion The incidence of severe acute hematological toxicity was significantly higher in this study than in previously reported randomized controlled trials (RCTs), especially in the group of 40 mg/m² cisplatin. A dose of 30 mg/m² of cisplatin was considered to be feasible in weekly cisplatin and radiation therapy.     

Proton Therapy for Head and Neck Malignancies at Tsukuba

PURPOSE: To evaluate the effectiveness and feasibility of proton therapy for head and neck cancers. PATIENTS AND METHODS: From 1983 to 2000, 33 patients with head and neck malignancies but no history of surgical resection were treated with 250-MeV protons with or without X-ray irradiation. This study retrospectively evaluated local control, survival, and treatment sequelae of these patients. The median total target dose using protons with or without X-rays was 76 Gy (range: 42-99 Gy) and the median proton dose per fraction 2.8 Gy (range: 1.5-6.0 Gy). RESULTS: Overall 5-year survival and local control rates were 44% and 74%, respectively. One (3%) and six patients (18%) suffered from treatment-related acute and late toxicity > grade 3 (RTOG/EORTC acute and late radiation morbidity scoring criteria). One patient with a history of radiotherapy suffered from acute toxicity > grade 3. CONCLUSION: Proton therapy appeared to offer high local control rates with few toxicities relative to conventional radiotherapy. However, late toxicity was seen in areas where large radiation doses had been given.     

The multimodality therapy of advanced inoperable esophageal carcinoma. A retrospective analysis]

BACKGROUND: The records of 161 patients with inoperable esophageal carcinoma were reviewed to determine the influence of concurrent radiochemotherapy and brachytherapy on overall survival. PATIENTS AND METHODS: From 1984 to 1999 161 patients suffering from advanced esophageal carcinoma Stage II to IV were treated with radiotherapy alone (131) or radiochemotherapy (30). In 48 patients additional brachytherapy was given. Median follow-up was 8 months (1 to 64 months), the median external beam doses was 51 Gy (18 to 66.6 Gy) and the median brachytherapy dose was 10 Gy (4 to 25 Gy). Chemotherapy consisted of cisplatin and 5-fluorouracil. RESULTS: Median survival for all patients was 10 months, 3-year survival rate 13% and the 5-year survival 5.2%. In univariate analysis the best results were achieved by concurrent radiochemotherapy with a median overall survival of 13 months, a 4-year survival of 18% (p = 0.0368), the combination of external radiotherapy and additional brachytherapy with a median overall survival of 14 months, a 4-year survival of 12.2% (p = 0.0008). After combination of concurrent radiochemotherapy and brachytherapy the 2-year survival rate is 58%. Multivariate analysis revealed simultaneous radiochemotherapy, external beam dose and additional brachytherapy as prognostic factors. Combination of concurrent radiochemotherapy and brachytherapy was possible without significant increase of local toxicity. CONCLUSIONS: Our retrospective analysis demonstrates that concurrent radiochemotherapy and additional brachytherapy are effective treatment schedules without significant increase of toxicity and may improve overall survival of patients with inoperable carcinoma of the esophagus. According to the results of this retrospective study, it would be appropriate to conduct a randomized trial to evaluate the benefit of combination of concurrent radiochemotherapy and brachytherapy.     

Ⅲ、Ⅳ级脑胶质瘤术后调强放疗联合替莫唑胺化疗的临床研究

目的评价Ⅲ、Ⅳ级脑胶质瘤术后调强放疗同步替莫唑胺化疗的疗效和毒副反应。方法回顾性分析我科2006年1月至2009年1月22例Ⅲ、Ⅳ级脑胶质瘤术后患者资料,所有患者采用调强放疗同步整合加量技术,处方剂量为PGTV 60Gy/25次,2.4Gy/次;PCTV 50Gy/25次,2.0Gy/次。其中有9例患者在放疗开始时口服替莫唑胺,剂量为150mg·m-2·d-1,连服5天,每4周为1个周期,最多连续服用6个周期。结果全组1、2年总生存率是68.8%、56%。平均生存时间12.1个月。单因素分析结果显示病理分级（χ2=15.232,P=0.000）和化疗（χ2=7.128,P=0.008）是影响预后的因素。多因素分析结果显示病理分级（P=0.002）是影响预后的独立因素。结论调强放疗同步整合加量技术同步替莫唑胺化疗是安全有效的,生存结果同历史对照相似。更确切的疗效需扩大病例数进一步研究。     

Concurrent Radiochemotherapy with Vinorelbine plus Cisplatin or Carboplatin in Patients with Locally Advanced Non-Small-Cell Lung Cancer (NSCLC) and an Increased Risk of Treatment Complications

BACKGROUND: In elderly patients, patients with multiple morbidities, and patients with a reduced general condition, the standard treatment of inoperable non-small-cell lung cancer (NSCLC) consists of either chemotherapy or radiation therapy alone and is associated with an extremely poor prognosis. We therefore investigated the feasibility, toxicity, and efficacy of radiotherapy with concurrent chemotherapy using vinorelbine plus cisplatin or carboplatin in NSCLC patients at risk for treatment complications. PATIENTS AND METHODS: A total of 33 patients (six women, 27 men, median age 65 years) with locally advanced, functionally inoperable pulmonary carcinomas, recurrent lung cancer or postoperative macroscopic residual tumors (R2) with an increased risk of treatment complications (WHO performance status 2/3; cardiac, renal or pulmonary failure; marked pretherapeutic weight loss; age between 71-75 years) received 12.5 mg of vinorelbine per m(2) body surface area (BSA) on days 1, 8, 15, 29, 36 and 43 plus either cisplatin 20 mg/m(2) BSA (ten patients) or carboplatin 70 mg/m(2) BSA (23 patients) on days 1-5 and 29-33 together with conventionally fractionated radiotherapy. The tumor regions were irradiated with doses of up to 63 Gy (90% isodose), and potentially affected lymph nodes received doses of up to 45.0 or 50.4 Gy (90% isodose). RESULTS: Briefly, 31 of 33 patients successfully completed radiation therapy and 26 received four cycles of vinorelbine plus at least two cycles of cisplatin or carboplatin. Hematotoxic side effects included grade III leukocytopenia (n = 8), grade III thrombocytopenia (n = 5), and grade IV thrombocytopenia (n = 2). Other side effects consisted of peripheral neuropathy grade III (n = 1) and esophagitis grade IV (n = 1). Severe pneumonitis did not occur. Six patients had pneumonia before radiochemotherapy. 21 patients (63%) exhibited a complete (n = 7) or partial response (n = 14) to chemoradiation. The twelve nonresponders had either stable (n = 9) or progressive disease (n = 3). The survival rates plus standard deviations were as follows: 1-year survival: 60 +/- 8%, 2-year survival: 36 +/- 9%, 3-year survival: 24 +/- 9%, median survival time: 17 months (5;29 months; 95% confidence interval [CI]), median progression-free survival: 11 months (9;13 months; 95% CI). The median follow-up time was 14 months. CONCLUSION: Conventionally fractionated radiochemotherapy with vinorelbine plus a platinum derivative is feasible in patients with NSCLC and increased risk of treatment complications. Compared to patient populations described in the literature, the survival rates achieved by concurrent radiochemotherapy appear to be better than those achieved with radiotherapy alone.