Abstract:

Objective To observe the efficacy and safety of threedimensional conformal radiotherapy （3DCRT） combined with chemotherapy for nonsmall cell lung cancer （NSCLC）， and analyze the factors influencing the prognosis of NSCLC patients. Methods One hundred and seven patients who were treated either by radiotherapy alone （26 patients） or radiotherapy plus chemotherapy （81 patients） from Jan. 2005 to Dec. 2008 were entered into the database for analysis. The radiotherapy dose was delivered at 2Gy／fraction， 5 fractions per week. The median total dose was 60Gy. The efficacy and toxicities were evaluated. Kaplan-Meier and Cox model were applied to analyze the survival of NSCLC. Results The response rate after 3DCRT was 61.7％（66／107） with complete remission 9.3％ （10／107） and partial remission 52.3％ （56／107）. The median followup time was 27 months， and 1-， 3-，5-year overall survival rates were 67％，31％ and 22％. The median survival time（MST） was 20.2 months. The Logrank test showed clinical stage， KPS performance， tumor volume， radiation dose，treatment regimen and response to treatment were correlated with overall survival. By Cox multivariable regression，the independent adverse prognostic factors were clinical stage， treatment type and response to treatment. Grade 2 acute radiation pneumonitis was observed in 3 patients and grade 3 in 2 patients. Late lung injury developed in 1 patient with grade 2， 1 patient with grade 3. Acute radiation esophagitis was observed in 49 patients with grade 1，above grade 2 developed in 9 patients. Acute grade 1，2 hematologic toxicity developed in 32 patients， above grade 2 developed in 5 patients. Conclusion 3DCRT combined with chemotherapy for NSCLC patients is effective and well tolerated. Clinical stage， treatment type and response to treatment may be the factors influencing the prognosis of NSCLC patients.