Accelerated hypofractionated 3-dimensional conformal radiotherapy vs conventional radiotherapy in locally advanced non-small cell lung cancer using PET/CT-derived plan: A prospectively randomized controlled trial
10.3781/j.issn.1000-7431.2014.03.009
- Author:
Xue-Juan YU
1
Author Information
1. Shandong Cancer Hospital, School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences
- Publication Type:Journal Article
- Keywords:
Carcinoma, non-small cell lung;
Chemotherapy;
Positron-emission tomography;
Prognosis;
Radiotherapy
- From:
Tumor
2014;34(3):253-259
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To prospectively evaluate the efficacy and adverse reactions of accelerated hypofractionated 3-dimensional conformal radiotherapy (3D-CRT) vs conventional radiotherapy in locally advanced non-small cell lung cancer (NSCLC) using positron emission computed tomography (PET)/computed tomography (CT)-derived plan. Methods: Between April 2009 and December 2011, sixty patients with locally advanced NCSLC were enrolled and randomly divided into group A (accelerated hypofractionated 3D-CRT using PET/CT-derived plan, n = 30) and group B (conventional radiotherapy using CT-derived plan, n = 30). All patients were treated with two cycles of induction chemotherapy (vinorelbine 25 mg/m2 d1, 8; cisplatin 40 mg/m2, d1-3; repeat every 21 days). The 30 patients in group A were treated with accelerated hypofractionated 3D-CRT (initially 2.5 Gy/fx, up to 50 Gy/20 fractions; then 3 Gy/fx, up to a total dose of 65 Gy). The 30 patients in group B were treated with conventional radiotherapy (60 Gy/30 fx). In addition, all patients were received at least one cycle of adjuvant chemotherapy of vinorelbine plus cisplatin. Results: In group A, 8 (26.7%) achieved complete response (CR), 13 (43.3%) achieved partial response (PR), and the objective response rate (CR+PR) was 70.0%; in group B, 4 (13.3%) achieved CR, 9 (30.0%) achieved PR, and the objective response rate was 43.3%; the difference in objective response rate between the two groups was significant (P = 0.037). The median survival time and the median progression-free survival time of group A were longer than those of the group B (20.5 vs 17.8 months, P = 0.236; 10.2 vs 8.2 months, P = 0.001). The major side effect induced by chemotherapy was marrow suppression which could be relieved by symptomatic treatment. The major side effects induced by radiotherapy were radiation-induced esophagitis and pneumonitis. Grade ? radiation-induced pneumonitis was observed in one and three patients in group A and group B, respectively; and Grade ? radiation-induced esophagitis was seen in one and two patients in group A and group B, respectively. There were no significant differences in the rates of side effects induced by radiation therapy between the two groups (P > 0.05). Conclusion: Accelerated hypofractionated 3D-CRT using PET/CT-derived plan combined with induction chemotherapy in the treatment of locally advanced NSCLC is effective and tolerable. Copyright © 2014 by TUMOR.
