Application of two-way shrinking field radiotherapy with high intensity in non-small cell lung cancer with stage Ⅳ / 中国综合临床

ABSTRACT

Objective To investigate the advantage of two-way shrinking field radiotherapy with high intensity on non-small cell lung cancer(NSCLC) with stage Ⅳ.Methods Forty-two old NSCLC patients with stage Ⅳ were selected as our subjects who cannot performed surgery in the People's Hospital of binzhou.The patients all underwent CT-scan and the CT information was input TPS planning system in order to outlined gross tumor volume(GTV1) and make plan 1 with the first three-dimensional conformal radiotherapy 50 Gy/25 F～ 54 Gy/27 F.Then the 2nd CT-scan was performed to sketch GTV2 and make Plan 2.The detail of Plan 2 was that the amount of radiation was increased to the total 66 Gy/33 F ～ 70 Gy/35 F,two radiotherapy plans in accordance with 1 times/d,5 times/weeks;chemotherapy with paclitaxel 40 mg/m2,weekly radiotherapy before the intravenous infusion,once every 6 weeks.Results The median of reduce tumor size between GTV2 and GTV1 was 68.85 cm3 and relative reduce tumor size was 28.32％.As to short-term effect,there were 5 cases with total recovery(1 1.9％),25 cases with partly recovery(59.5％),10 cases with stable stage (23.8 ％),2 cases with development(4.8％).Local control rate regarding of tumor development was 71.4％ at 1-yrea period and 23.8％ at 2-year periods.Survival rate was 73.8％(31/42) at 1 year and 28.6％(12/42) at 2-year.Side effects included radiation esophagitis and radiation pneumonitis based,radiation-induced lung injury.Condusion The therapy scheme of two-way three-dimensional conformal radiation dosage treatment of NSCLC,GTV and re-plan outlined dosage can increase the target dose,radiation therapy to reduce side effects.