OBJECTIVETo evaluate the therapeutic efficacy of three-dimensional conformal radiotherapy (3DCRT) combined with stereotactic radiotherapy (SRT) and the radiation-induced complications in patients with locally advanced non-small cell lung cancer (NSCLC).

METHODSSixty-eight patients with locally advanced NSCLC were randomly divided into two groups. The 33 patients in groups A received 3DCRT at the total dose of 66 to 70 Gy in 33 to 35 fractions, and the 35 patents in group B received stereotactic radiotherapy (SRT) at the dose of 20 Gy in 4 fractions (500 cGy per fraction every other day) after 60 Gy 3DCRT.

RESULTSThe total response rates in groups A and B were 56.3% and 80.0%, with the complete remission rates of 9.4% and 28.6%, respectively, both showing significant differences between the two groups (P<0.05). The 1- and 2-year survival rates of the patients in group A were 65.6% and 46.8%, respectively, which were comparable to those in group B (74.3% and 51.4%, respectively, P>0.05). The median survival time in groups A and B were 12.6 and 18.3 months, respectively. The major radiation-induced complications in the two groups included grade I to II acute radiation esophagitis and hematopoietic toxicity. The complications in later stages following the radiation were grade I to II radiation lung fibrosis, occurring at a similar incidence between the two groups.

CONCLUSIONThe combination of 3DCRT and SRT produces better therapeutic effects than 3DCRT alone in patients with locally advanced NSCLC.