Chinese Clinical Oncology
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Abstract: ObjectiveTo evaluate the efficacy and toxicity of docetaxel combined cisplatin concurrent chemoradiotherapy with later stereotactic body radiotherapy(SBRT) in treatment of locally advanced nonsmall ceIl lung cancer(LANSCLC). Methods A total of 32 eligible patients diagnosed with inoperable LANSCLC(ⅢA or ⅢB) were assigned to treat with docetaxel combined cisplatin chemotherapy at least 3 or 4 cycles(docetaxel 75 mg/m2 on day 1,and cisplatin 20 mg/m2 on day 1-4,repeated every 3-4 weeks). The concurrent thoracic radiotherapy was given within one week after the first chemotherapy cycle in all patients. The primary tumors and involved lymph nodes were administrated threedimensional conformal radiotherapy(3DCRT) with a total dose of 50 to 60Gy(200cGy/fraction,5f/week,completed in 5 to 6 weeks)in all patients. After 4-6 weeks of 3DCRT,all patients received computerized tomographic scanning and those with residual tumor lesions were administrated additional stereotactic body radiotherapy(SBRT) with the doses of 18-27Gy(300cGy/fraction,every other day) and without exceeding the tolerated doses of surrounding important normal organ. The efficacy was evaluated according to RECIST criteria.The toxicities were evaluated according to NCI CTC 3.0 criteria and RTOG/EORT radiation reaction criteria. Results All the patients finished the planed concurrent chemoradiotherapy and later SBRT. Though the response rate(RR)raised to 81.2%(26/32)after SBRT,the differences were not significant compared with 68.8%(22/32)after 3DCRT(P>0.05).Till the last follewup day,time to progression(TTP)and median survival time(MST) were 12.6 month and 21.8 month, respectively. 1-year progression free survival rate and 1year and 2year overall survival rate were 59.4%,81.3%,46.9%, respectively.The main toxicities were myelosuppression,nausea and vomiting,acute radiation pneumonitis and acute radiation esophagetis. All the toxicities could be relieved and tolerated after appropriate treatment. ConclusionConcurrent chemoradiotherapy with later SBRT can be considered as an effective and feasible approach in treatment of choosed LANSCLC.
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http://manu65.magtech.com.cn/Jwk3_lczlxzz/EN/Y2012/V17/I9/840
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