Different fractionated three dimensional conformal radiotherapy versus conventional radiotherapy in non- small cell lung cancer

Objective To compare the effectiveness and side effects of different fractionated three dimensional conformal radiotherapy (3DCRT) and conventional radiotherapy (CRT)in patients with non-small cell lung cancer (NSCLC). Methods From June 1997 to June 2002, 207 cases of NSCLC treated by 3DCRT or CRT were divided into three groups (3DCRT Ⅰ group, 3DCRT Ⅱ group and CRT group) in terms of different radiation therapy and fractioned dosage. 3DCRT Ⅰ group (57 patients) was irradiated with 5 to 6 Gy every other day (total 48 to 50 Gy) and there were 8 to 10 radiotherapies during 18 to 22 d. 3DCRT Ⅱ group (69 patients) had a single dose of 2 Gy and was irradiated every day (total 66 to 70 Gy), and there were 33 to 35 radiotherapies during 45 to 49 d. C RT group (81 patients) was treated with a daily dosage of 2 Gy (total 66 to 70 Gy), and there were 33 to 35 radiotherapies during 45 to 49 d. The effectiveness and side effects were compared in 3 groups. Results The survival rates of 1-, 3- and 5-year in 3DCRT Ⅰ group were 84.2% (48/57), 40.4% (23/57) and 17.5%(10/57) respectively;in 3DCRT Ⅱ group were 76.8% (53/69), 31.9% (22/69) and 13.0% (9/69) respectively;and in CRT group were 65.4% (53/81), 23.5% (19/81) and 8.6% (7/81) respectively. There was significant difference in improvement rate of local lesion and survival curve (all P<0.05). The side effects including radiation pulmonary fibrosis and radiation esophagitis appeared in all three groups. The rate of side effect was highest in CRT Group (P<0.05). Conclusion 3DCRT is an effective therapy for NSCLC, which possesses better efficacy and less side effect compared with other two methods. Key words: Carcinoma;  non-small cell lung; Radiotherapy; Three dimensional conformal radiotherapy; Dosage fractionation; Treatment effectiveness