Evaluation The Three-dimensional Changes For The Recent Efficacy Of Pre And Post Concurrent Radiochemotherapy In Locally Advanced Non-small Cell Lung Cancer

Objective: To analyze the evaluation of GTV three-dimensional volume change for short-term efficacy in locally advanced IIB-IV non-small cell lung cancer after concurrent radiochemotherapy.Methods: From Sep.2012 to Oct.2014,16 patients with locally advanced non small cell lung cancer had been enrolled for the trial in Qingdao municipal hospital.There were 12 males and 4 females.Age32 ～ 78,the median age at the age of 62.Confirmed by pathology or cytology for non-small cell lung cancer.TNM staging AJCC2002 years announced: the stage IIB 1 case,stage IIIA,7 cases of stage IIIB in 5cases,IV in 2 cases,10 cases were squamous carcinoma,adenocarcinoma,6 cases;KPS score: 90 points in 2 cases,10 cases of 80 points,70 points in 4 cases.Treatment: Chemotherapy regimens Adopt etoposide combined cisplatin(EP)scheme,etoposide 50 mg/m2 1-5,29-33 days,cisplatin 50mg/m2 1,8,29,36 days.Radiation therapy plan The medical linear accelerator 6 mv-routine X-ray dose of intensity-modulated radiotherapy(IMRT)technology,95% plan target PTV50-56 gy,25 to 28 times,a total of 5-6 weeks.Before and after 1 month treatment measure of the tumor’s two biggest hangs longest diameter and diameter,and sketch the tumor before and after treatment of GTV volume change.applying SPSS15.0statistical software to calculate the consistency of three-dimensional GTV volume changes between WHO and RECIST criteria.Results: 1 This study follow-up deadline is December,2014,1months follow-up time.The follow-up rate was 100%,16 patients all completed the concurrent chemoradiotherapy.2 The short term effects: All patients accepted a month follow-up after concurrent radiochemotherapy,3 CR cases,8 PR cases,3 SD cases and 2 PD cases in RECIST criteria group;3 CR cases,7 PR patients,6SD cases without PD patients in WHO standard group.According to GTV standard 9 cases of CR,PR is 3 cases,1 case of SD,3 cases of PD.3 The toxic effects: After chemoradiation in patients with acute toxicity reaction mainly for bone marrow suppression,radioactive pneumonia and I-II level radioactive esophagitis,no serious heart,lungs and spinal cord,esophageal acute radiation injury,no serious liver and kidney function damage and allergic reactions.Bone marrow inhibition rate was 75%(12/16),characterized by white blood cells and neutrophils count down,including grade 1 in 5 cases(31.25%),2 levels of 4 cases(25%),grade 3 in 2 cases(12.5%),grade 4 in 1 case(6.25%).There were another 5 cases(31.25%)patients appeared I ～ III platelets to fall,after symptomatic treatment did not affect the chemoradiation.In acute pneumonia after 8/16,the incidence was 50%,including grade 1 in 3patients(18.75%),2 levels of 4 cases(25%),grade 3 in 1 case(6.25%),no 4th level radioactive pneumonia.Acute radiation esophagitis in 9/16,the incidence of 56.25%,among them 1 level 4 cases(25%),grade 2 in 3patients(18.75%),grade 3 in 2 cases(12.5%),grade 4 was not occurred.4 According to the statistical analysis,the Kappa value between RECIST and GTV was 0.711 ± 0.142;between WHO and GTV was0.512 ± 0.186.Conclusions: the consistency between GTV dimensional volume change for recent effect and WHO standard in locally advanced non-small cell lung cancer after concurrent chemoradiotherapy was better,but the consistency with RECIST criteria was poor.