Clinical Trial On Locally Advanced Non Small Cell Lung Cancer Treated By Cyberknife Combined With Chemotherapy

Purpose: To discuss the short-term curative effect and safety of Cyberknife combined with standard chemotherapy for local advanced non-small cell lung cancer.Method: 60 patients with non-small cell lung cancer of oncology department in Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine were enrolled from March 2014 to August 2015,randomly divided into experimental group and control group,30 cases in each group,the experimental group gave 2 circles' chemotherapy first,then followed with radiotherapy by Cyberknife after being assessed without radiation therapy contraindications,2 weeks after Cyberknife treatment concluded,2 more circles' chemotherapy were continued;the control group adopted standard chemotherapy alone.Made a comparison of CT reexamination results at the end of two groups,observe patients' local tumor response rates,KPS score changes and treatment-related toxicity of each group,then evaluate their short-term curative effect,quality of life and safety.Result: 55 patients with a total of 76 tumor focuses included came into the final analysis,The short-term response rate were 78.5% in experimental group and 37.0% in control group,P<0.05;Outcome of single independent variable analysis in the subgroup of experimental group has shown that patients with tumor baseline-diameter ? 5 cm,age ? 60 years or biological effective dose(BED)> 100 Gy got a higher response rate significantly,P<0.05,but after took all these variables into binary logistic regression,no statistical significance has been found in the parameter test,P > 0.05;Patients' posttreatment KPS scores of the two groups were both significantly promoted(P<0.05)and the experimental group is higher than control group(P < 0.05);Experimental group got a higher occurrence rate of myelosuppression,gastrointestinal reaction than control group,P<0.05,part of patients treated by Cyberknife got mild adiodermatitis and radiation pneumonia,no level III or above adverse reactions has been seen,experimental group got 3 cases of pneumothorax(2 cases of RTOG level I,1 case of level II)and 1 case of mild hemoptysis,all these adverse reactions and complications could get remission after symptomatic support therapy,hadn't affected the follow-up treatment.Conclusion: Cyberknife combined with standard chemotherapy have better short-term curative effect than chemotherapy alone for local advanced non-small cell lung cancer.It can improve patients' quality of life,and no obvious increase of level III or above adverse reaction has been seen in this regimen compared with chemotherapy alone.It is worth promoting by its good clinical practicality.