Prognosis of locally advanced non small cell lung cancer treated with three dimentional conformal radiotherapy.
- Author:
Xiang-Zhi ZHU
1
;
Lü-Hua WANG
;
Guang-Fei OU
;
Zong-Mei ZHOU
;
Dong-Fu CHEN
;
Ze-Fen XIAO
;
Qin-Fu FENG
;
Hong-Xing ZHANG
;
Mei WANG
;
Wei-Bo YIN
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; therapeutic use; Bone Neoplasms; secondary; Brain Neoplasms; secondary; Carboplatin; administration & dosage; Carcinoma, Non-Small-Cell Lung; drug therapy; pathology; radiotherapy; secondary; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Karnofsky Performance Status; Lung Neoplasms; drug therapy; pathology; radiotherapy; Male; Middle Aged; Neoplasm Staging; Paclitaxel; administration & dosage; Particle Accelerators; Proportional Hazards Models; Radiotherapy Dosage; Radiotherapy Planning, Computer-Assisted; methods; Radiotherapy, Conformal; methods; Remission Induction; Survival Rate
- From: Chinese Journal of Oncology 2007;29(10):748-753
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo summarize our experience and evaluate the prognostic factors of locally advanced non small cell lung cancer (LA-NSCLC) treated with three dimentional conformal radiotherapy (3D-CRT).
METHODS118 patients with stage IIImA/IIIB non small cell lung cancer were treated with 3D-CRT from Nov. 2001 to Mar. 2005. 113 patients with complete clinical data were eligible for analysis, 45 of them received radiotherapy alone; 39 were treated by concurrent chemoradiation with paclitaxol plus carboplatin in 32 patients and topotecan in 7 patients, and 29 by sequential chemoradiation with platinum-based regiment in most of them. The dose of radiation for the thoracic field ranged from 26 Gy to 75 Gy with a median dose of 60 Gy. GTV and PTV were collected from the 3D treatment plans in 79 and 101 patients, respectively. Overall survival (OS) was calculated using the Kaplan-Meier method. Comparisons among the curves were made using a two-tailed long-rank test. The Cox model was used for multivariate analysis.
RESULTSThe 1-, 2- and 3-year overall survival rate was 60.7%, 31.6% and 22.4%, respectively, with a median survival time of 17 months. In univariate analysis, the following characteristics were significantly associated with longer survival: absence of chest pain, good karnofsky performance status (KPS), albumin > 4.2 g/L, hemoglobin > or = 140 g/L (male) or 130 g/L (female), response to radiotherapy and GTV < 100 cm3. However, multivariate analysis revealed that only good KPS was an independent risk factor predicting the survival.
CONCLUSIONThree-dimensional conformal radiotherapy is effective in the treatment of locally advanced non-small cell lung cancer with acceptable complications. Karnofsky performance status is the only independent prognositic factor.