The Exploration And Discussion Of The Effect Of Different Radiation Doses In Non-Small Cell Lung Cancer

Objective:To explore the influence of different radiation dose on the disease control rates and progression-free survival and adverse reactions of patients with inoperable non-small cell lung cancer who are not stage Ⅳ.Methods:Retrospective analysis of 102patients with non-small cell lung ca ncer of clinical data, the patients diagnosis and treatment by different radiothera py dose of chemoradiotherapy or radiotherapy alone in Guangxi medical univer sity affiliated tumor hospital from December 2002 to December 2014. Accordin g to the radiation dose(converted to regular amount by BED biological equivale nt formula),102 patients were divided into two groups:32 cases of< 60 Gygro up,70 cases of ≥60 Gygroup, then two groups were observe the therapeutic ef fect of short-term and the incidence of radiation pneumonitis mainly,then secondary outcome for the effect of the long-term curative. They were analyzed after dividing by radiation way and whether combine chemotherapy again.Results:The DCR (Disease Control rates) of the radiation dose<60 Gy group and≥60 Gy group were 68.8% and 85.7%,the DCR of≥60 Gy group was higher than< 60 Gy group, and the difference between two groups in DCR was statistically significant (P=0.045). They were analyzed after dividing by radiation way, there was no significant difference between the DCR of the 3-dimensional conformal radiation therapy group and the two-dimensional conventional radiotherapy; DCR of three -dimensional group was obviously higher than the two-dimensional group in ≥60 Gy group, and there was obvious difference between two groups (P=0.044). They were analyzed after dividing by whether combine chemotherapy again, DCR of the chemoradiotherapy group was only slightly higher than the group which radiotherapy alone, but there was no statistical difference between two groups; however, DCR of the chemoradiotherapy group was obviously higher than the radiotherapy alone group in ≥60 Gy group, and there was obvious difference between two groups (P=0.046). The 1 year,3 years and 5 years survival rate of < 60 Gy group and ≥60 Gy group were 45.2%、14.3%、3.1%与73.3%、22.7%、 9.8% respectively, with significantly difference (P=0.034, P=0.041, P= 0.036).The median PFS of<60 Gy group and ≥60 Gy group were 5 months and 9 months(P=0.002), The median OS were 7 months and 9 months respectively, with significantly difference (P=0.025). Multiple factors analysis showed that radiotherapy dosage and the methods of radiotherapy had significant correlation with the incidence of radioactive pneumonia. And V20 (P =0.01), V30 (P=0.002) and MLD(P=0.03) in radiation therapy group were associated with the incidence of radioactive pneumonia.Conclusion:The disease control rates and PFS and Overall survival of radiation dose^60 Gy group was better than< 60 Gy group, it is suggested that the radiation dose should be given above 60 Gy under the condition of the normal tissue tolerance allowed.3DCRT and IMRT can improve the disease control rates better than the Two-dimensional conventional radiotherapy. The comprehensive treatment efficacy of radiotherapy combined chemotherapy was superior to that of simple radiotherapy. Radiotherapy dosage, the methods of radiotherapy,V20, V30 and MLD were associated with the incidence of radioactive pneumonia.