Three Dimensional Conformal Radiotherapy With Weekly Paclitaxel And Carboplantin For Locally Advanced Non Small Cell Lung Cancer

Background:Almost one million new cases of lung cancer occur worldwide each year.Non-small cell lung cancer(NSCLC) accounts for approximately 75%-85%of all cases,2/3 of patients confirmed to have been lost surgery, which isâ…¢B-â…£patients with poor prognosis.Randomized clinical trials and meta-analysis found that concurrent radiochemotherapy can effectively raise the survival rate of the unresectable patients with Stageâ…¢and is the current standard treatment modalities,paclitaxel -based concurrent radiochemotherapy is one of the relatively respected comprehensive treatment of lung cancer.The biological mechanism of concurrent radiochemotherapy is complex,now it is thought to be related to cell cycle arrest,inducing cell apoptosis and re-oxygenation of the redidued hypoxia cells.There is many problems in the election of the modality of radiochemotherapy,such as the chemotherapeutics,the modus, the juncture,the dosage,and so on.Objective To evaluate the efficacy and toxicity of Three dimensional conformal radiotherapy with weekly paclitaxel and carboplatin for locally advanced non small cell lung cancer(NSCLC). Methods 94 patients with locally advanced NSCLC were randomly placed to three groups:the concurrent chemoradiation group A(n=33),the concurrent chemoradiation group B(n=29),and the sequential chemoradiation group(n=32).The three group were all given 3D-CRT at 2Gy/f to a total dose of 70Gy.In the concurrent chemoradiation group A,paclitaxel 50mg/m~2,and carboplatin of 1.5AUC/cycle was given on D1,D8,D15,D29,D36 and D43.In the concurrent chemoradiation group B,the method is the same of group A,except paclitaxel 40 mg/m~2.In the sequential chemoradiation group,two cycle of chemotherapy were given at two weeks before radiotherapy.Paclitaxel 150 mg/m~2 and carboplatin 5 AUC/cycle were administered on D1 and D21.Results The effective power[complete response(CR) +partial response(PR)]of concurrent chemoradiation groupA,B and sequential chemoradiation group was 81.8%,79.3%,56.2%.The median survival time was 18.8 months for concurrent chemoradiation groupA,17.6 months for concurrent chemoradiation groupB and 15.6 months for sequential chemoradiation group.The 1-,2-year survival rate was 74.0% and 41.0%;72.0%and 39.0%;69.0%and 35.0%,respectively.â…¡-â…¢grade of esophagitis,pneumonia and leukocytonpenia in the three group was 60.6%,24.2% and 42.4%;58.6%,24.1%and 44.8%;40.6%,21.9%and 18.8%,respectively.Conclusion Weekly paclitaxel and carboplatin with three dimensional conformal radiotherapy may be helpful in improving response and survival than sequential one, but there is a adscendent tendency in adverse reaction..Subject words Carcinoma,non-small-cell lung;Radiotherapy,conformal; Chemotherapy,adjuvant;Taxus...