| Purpose:This study objectives were to inquiry into the best treatment mode of the loca -lly advanced unresectable non-small cell lung cancer Medhod .Materials: Patients with histologically proven and unresectable Stage III NSCLC,good performance status and minimal weight loss were enrolled into a prospective randomized this study .The patients were randomized into four treatment groups: 1 Sequential chemoradiotherapy and regulatiotion fractionated radiationtherapy ;2.Concurrent chemoradiotherapy and regulatiotion fractioned radiationtherapy ;3 Concurrent chemoradiotherapy and late course hyperfractionated accelerated radiotherapy ;4 Concurrent chemoradiotherapy and hyperfractionated radiotherapy in whole course.all patients were to finish four cycles NVB/PDD.To compare the fourer groups efficacy ,toxicity,and the variety of th- e T helper typel and type2(Thl,Th2, Thl/Th2) and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/ CD8+) of the peripheral blood mononuclear cells , to judge dissimilarity influence of the treatment method upon the immunity function and the relation between the T helper cell (Th1, Th2) variety and the lymphocyte subset variety .the immunol -ogy detection : through quantifing the blood plasma IFN-γ, IL-4,foundout the activity of the Thl, Th2 respectively;Adopting enzyme-linked immunosorbent assy to examine the peripheral blood lymphocyte subset (CD3+, CD4+, CD8+).Results 1 Efficiency: For -m high to low: Concurrent chemoradiotherapy and late course hyperfractionted accele -rated radiotherapy,Concurrent chemoradiotherapy and hyperfractionated radiotherapy in whole corse therapy , Concurrent chemoradiotherapy and regulation fractioned radia -tion therapy Sequential chemoradiotherapy and regulation fractionated radiation.the response rate(CR+PR) respectively were82.75%% 82.14%% 79.3%> 53.3%.There were significant difference between the three concurrent groups and the sequential groups (p<0.05),There were not significant difference between the three concurrent groups (p>0.05). 2 Hematological toxicity (leucopenia) The grade I , II ,111, IV Sequential chemoradiotherapy and regulation fractionated radiation therapywere43.33%% 23.33%% 6.67%% 3.33% respectively cocurrent chemoradiotherapy and regulation fractioned radiationtherapy were 31.03%% 34.48%% 17.24% % 3.44%,Concurrent chemoradiotherapy and late course hyperfractionated accelerated radiotherapy were 17.24%% 37.93%% 24.13%% 10.34% respectively;Concurrent chemoradiotherapy and hyper fractonated radiotherapy in whole course were 21.42%% 35.71%% 28.57%% 10. 71% respectively. There were not significant difference in the four groups for the whole hematologic toxicity (p>0.05),there were significant difference between the four groups(p<0.05) for the grade III+IVtoxicity . there were not significant difference between the three concurrent groups for the grade III+IVtoxicity(p>0.05). ?Esophagitis.The grade 1,11,111,1V toxicity for esophagus: Sequentialchemoradiotherapy and regulation fractionated radiation therapy were 30.33%% 13.33%% 6.67%% 0% respectively; Concurrent chemoradiotherapy and regulation fractioned radiation therapy were 27.58% % 24.13%% 17.86% % 0% respectively; Concurrent chemoradiotherapy and late course hyperfractionated accelerated radiotherapy 37.93%% 20.68% % 13.79% % 3.44% respectively -, Concurrent chemoradiotherapy and hyperfractionated radiotherapy in whole course were 32.14%% 32.14%% 21.42%% 3.57% respectively.there were significant difference between four groups (p<0.01) for the allgrade toxicity .there were not significant difference between the three concurrent groups for the all grade toxicity (p>0.05). Bronchopulmonaritis toxicity:The grade I ,11,111,IV toxicity for bronchopulmonary:Sequential chemoradiotherapy and regulation fractionated radiation therapy were 16.67% . 6.67% > 0% . 0% respectively ; Concurrent chemoradiotherapy and regulation fractioned radiation therapy were 24.13%> 13.79%^ 3.45%. 0% respectively; Concurrent chemoradiotherapy and late course hyperfractionated accelerated radiotherapy 24.13%. 17.24% > 6.89%. 0% respectively; Concurrent chemoradiotherapy and hyperfractionated radiotherapy in whole course were 28.57%. 21.42 %. 7.14%. 3.57% respectively.there were significant difference between the four groups (p<0.05) for the all grade toxicity .there were not significant difference between the three concurrent groups forthe all grade toxicity (p>0.05). The immunity influenc -e For the later period lung cancer patients,the Thl and TH1/TH2 in the peripheral blood showed significantly decrease than the normal, the TH2 was then contrary (p<0.01).For the completel response patients(CR ) ,there were increased trend on Thl and TH1/TH2 and there were decreased trend on Th2 after treatment, the difference did not showed absolutely significant(p>0.05),the other patients(PR+NC+PD) , the variety of Thl and thl/th2 keeped up decline and the Th2 keeped up increases after the impair -ment of radiotherapy and chemotherapy (p<0.01) .the varity about T lymphocyte subsets (CD3+,CD4+, CD4+/ CD8+) of the peripheral blood mononuclear cells express the similitude trend , CD3+, CD4+ CD4+/ CDg+ showed significan decline(P<0.01)than normal person, the CD8+ was then contrary(p<0.05).For the completel response patients(CR ) ,there were increased trend on CD4+ and CD4+/ CD8+and there were decreased trend on CD3+ CD8+ after treatment, the difference did not show significant (p>0.05)as the T helper cells .the other patients (PR+NC+PD) ,the variety of CD3+, CD4+and CD4+/ CD8+ keeped up...
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