RESUMEN
Objective: To analyze the feasibility of omitting clinical target volume (CTV) for patients with stage III non-small cell lung cancer (NSCLC) treated with intensity-modulated radiotherapy (IMRT). Methods: Data of 105 patients with stage III NSCLC who were hospitalized and received IMRT in Department of Radiotherapy of Peking University Cancer Hospital from January 2008 to November 2012 were retrospectively analyzed. There were 73 cases of squamous cell carcinoma and 32 cases of adenocarcinoma. Of 105 cases, 55 were irradiated with target volume without CTV, and 50 cases were irradiated with CTV. Dose prescription was 95% planning target volume (PTV) 54-63 Gy/27-35 fx/5.4-7.0 weeks. Results: In the arm without CTV and arm with CTV, the local relapse rates were 32.7% and 32.0%, and the distant metastasis rates were 56.4% and 48.0%, respectively (P > 0.05). The median progression-free survival was 9 months in both groups. The 1-year, 2-year and 3-year survival rates in irradiation with target volume without CTV group were 74.5%, 43.6% and 23.6%, respectively; which were 70.0%, 46.0% and 20.0%, respectively in irradiation with target volume with CTV group (all P > 0.05). The grades 1-2 radiation pneumonia rates in irradiation with target volume without CTV group and with CTV group were 94.5% (52/55) and 82.0% (41/50), respectively, and the grades 3-4 radiation pneumonia rates were 5.5% (3/55) and 18.0% (9/50), respectively (P = 0.044). Conclusion: Omitting CTV for patients with stage III NSCLC treated with IMRT can not increase the rates of local recurrence and distant metastasis, and not decrease the progression-free survival and overall survival, but obviously decrease the rate of grades 3-4 radiation pneumonia.