Three-dimensional Conformal Radiation Therapy For Locally Advanced Lung Cancer Prognosis And Toxicity Analysis

Objective: To evaluate our institution's experience and identify prognostic factors for LA-NSCLC using 3D conformal radiotherapy. Methods one hundred and eighteen patients with stage Ⅲ A/B non-small-cell lung cancer (LA-NSCLC) were treated with 3D-CRT at CAMS from Nov. 2001 to Feb. 2005. 113 patients were eligible to analyse. 45 cases received radiotherapy alone; 39 cases received concurrent chemoradiation (paclitaxol plus carboplatin in 32 patients, Topotecan in 7 patients); 29 cases received sequential chemoradiation, mostly with platinum-based regiment. Thoracic radiation dose ranged from 26Gy to 75Gy (median 60Gy). GTV and PTV were collected from the 3D treatment plans in 79 and 101 patients, respectively. Results The overall 1,2 and 3-year overall survival rate was 61.4%, 32.1% and 22.7%, respectively, with a median survival time of 17 months. In univariate analysis, the following characteristics were significantly associated with survival: absence of chest pain, good karnofsky performance status (KPS), albumin>4.2g/L, hemoglobin≥140g/L and 130g/L for male and female, respectively, response to radiotherapy and GTV<100cm3. Multivariate analysis revealed that good KPS was the only independent risk factor for survival. Conclusion Three-dimensional conformal radiotherapy is effective in the...