Abstract

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Title:: Simultaneous modulated accelerated radiotherapy combined with chemotherapy for the treatment of locally advanced non-small cell lung cancer: a prospective study

Author(s):: HUANG Lisheng1; WU Fangcai1; LIN Baihan1; XU Yiwei2; LI Dongsheng1; CHEN Jie1; 1. Department of Radiotherapy, Cancer Hospital of Shantou University Medical College, Shantou 515041, China 2. Department of Clinical Laboratory, Cancer Hospital of Shantou University Medical College, Shantou 515041, China

Keywords:: Keywords: non-small cell lung cancer simultaneous modulated accelerated radiotherapy concurrent radiochemotherapy therapeutic effect

Abstract:: Abstract: Objective To investigate the therapeutic effect and safety of simultaneous modulated accelerated radiotherapy (SMART) combined with chemotherapy in the treatment of locally advanced non-small cell lung cancer (NSCLC). Methods Forty-eight cases which were newly diagnosed with stage Ⅲ locally advanced NSCLC were treated by concurrent chemoradiotherapy using SMART combined with paclitaxel and carboplatin. The prescribed doses were 69 Gy (2.3 Gy/F) for primary lung lesion PTV1, 64 Gy (2.13 Gy/F) for metastatic lymph nodes PTV2, and 60 Gy (2.0 Gy/F) for subclinical lesion volume PTV3. Dosimetric analysis was carried out on the radiotherapy plans. Moreover, overall survival, progression-free survival, overall response rate and acute toxicity were analyzed. Results All the 48 patients completed the course of concurrent radiochemotherapy. The Dmean to PTV1, PTV2 and PTV3 were (70.3±2.4), (66.5±2.1) and (64.5±3.1) Gy, respectively. The median overall survival and progression-free survival were 22.0 months and 17.0 months, respectively and the overall response rate was 72.9% and the 1-year and 2-year survival rates were 78.7% and 45.8%, respectively. No serious esophagitis, pneumonitis and cardiotoxicity were found. Conclusion SMART combined with chemotherapy is effective in the treatment of locally advanced NSCLC, with tolerable acute toxicity, but more follow-up is required to evaluate the late toxicity.