Therapeutic Efficacy Of Stereotactic Radiotherapy With Gamma Knife On Early-Stage Non-Small Cell Lung Cancer And Life Quality Of Patients

Objective To evaluate the therapeutic efficacy of stereotactic body radiotherapy(SBRT) with gamma knife (GK) on stage Ⅰ-ⅡNon-small cell lung cancer (NSCLC) and the quality of life of the patients undergoing this therapy.Methods Twenty NSCLC patients with the median patient age of76,10at stage Ⅰ,10at stage Ⅱ who were unable or unwilling to undergo surgery were given SBRT with GK at the dose of3-6Gy in8-15fractions, finished within2to3weeks. The prescription isodose line was50%, the marginal dose was39-56Gy the central dose was78-112Gy, and the total biologically effective dose was51-83Gy. The patients were observed after admission and followed up by chest CT1,3,6and12months after treatment until progressive disease or death. EORTC QLQ-LC43questionnaire were used to investigate changes in quality of life.Results The20patients were followed up for24(12～46) months. Six months after the treatment the overall response rate was80%, and the complete response rate was35%. The1,2and3-year local control rates were100%,95%and95%respectively; The1,2and3-year overall survival rates were95%,80%and50%respectively; The1,2and3-year progression free survival rates were85%,64%and33%respectively. The3-year failure rate was20%, and the rate of progress within the planning target volume was5%. No acute toxicity at grade and over occurred in any patient during the treatment.15%of the patients developed Grade1-2radiation pneumonia; Age, gender, with pathology or not were weakly correlated with the overall survival (all P>0.05). The emotional function was improved significantly after treatment (P<0.02), dyspnea and cough were improved at different degrees, however not significantly. And there were not obvious changes in the physical function and symptoms, such as fatigue and lack of appetite, insomnia of EROTC QLQ-LC43.Conclusions SBRT significantly improves the emotional function and maintain quality of life. SBRT with GK is effective for elderly NSCLC patients with high local control rate, fair overall survival rate, and few side effects.