后程三维适形放疗治疗Ⅲ期非小细胞肺癌临床研究

Late course three-dimensional conformal radiotherapy in patients with stage III non-small cell lung cancer]

OBJECTIVE: To evaluate the therapeutic efficacy and radiation complications of late course three-dimensional conformal radiotherapy (3DCRT) in patients with stage III non-small cell lung cancer (NSCLC). METHODS: Eighty-six patients with stage III NSCLC were randomly divided into group A (n=42) receiving conventional radiotherapy at the total dose of 66 to 70 Gy in 33 to 35 fractions completed in 6 to 7 weeks and group B (n=44) with late course 3DCRT at the dose of 24-30 Gy in 6 fractions (400-500 cGy per fraction every other day) after 40 Gy conventional radiotherapy, completed in 5 to 6 weeks. RESULTS: The efficacy rates in groups A and B were 55.0% and 82.9%, and the complete remission rates were 7.5% and 31.7% respectively, showing significant difference between the two groups (P<0.05). The 1- and 2-year survival rates of the patients in group A and B were 62.5% vs 78.0%, and 40.0% vs 53.7% respectively, without significant difference (P>0.05). The median survival time in groups A and B were 11.4 months and 19.8 months respectively. The major radiation complications observed in the two groups were grade I to II acute radiation esophagitis and hematopoietic toxicity. The later stage radiation complications in the two groups were grade I to II radiation lung fibrosis, occurring at a similar rate between the two groups. CONCLUSION: Late course 3DCRT produces better therapeutic effects than conventional radiotherapy in patients with stage III NSCLC.