| YANG Kun-yu,CAO Feng-jun,WANG Jian-hua.Improved local control without elective nodal in unresectable NSCLC patients treated by 3D-CRT[J].Chinese Journal of Radiological Medicine and Protection,2007,27(5):480-482 |
| Improved local control without elective nodal in unresectable NSCLC patients treated by 3D-CRT |
| Received:August 28, 2006 |
| DOI： |
| KeyWords:Non-small cell lung cancer(NSCLC) Elective nodal irradiation Three dimensional conformal radiotherapy |
| FundProject: |
| Author Name | Affiliation | E-mail | | YANG Kun-yu | Wuhan Union Hospital Cancer Center, Huazhong University of Science and Technology, Wuhan 430023, China | | | CAO Feng-jun | 湖北省十堰市人民医院肿瘤中心 | | | WANG Jian-hua | 浙江省瑞安市人民医院放疗科 | | | 刘莉 | Wuhan Union Hospital Cancer Center, Huazhong University of Science and Technology, Wuhan 430023, China | | | 张涛 | Wuhan Union Hospital Cancer Center, Huazhong University of Science and Technology, Wuhan 430023, China | | | 伍钢 | Wuhan Union Hospital Cancer Center, Huazhong University of Science and Technology, Wuhan 430023, China | wugangzr@yahoo.com.cn |
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| Abstract:: |
| Objective To investigate the influence of prophylactic elective nodal irradiation (ENI) on therapeutic results of definitive radiotherapy for patients with unresectable non-small-cell lung cancer. Methods 55 patients with inoperable advanced stage non-small-cell lung cancer were recruited. After 2-4 cycles of induction chemotherapy, patients were randomly divided into two groups prospectively. For one group, regions of elective nodal irradiation were included in target volumes; for the other group, regions of elective nodal irradiation were not included. Results The mean prescription doses to gross tumor volumes with ENI and non-ENI were 58.4 Gy and 65.8 Gy (P<0.05), the responsive rates were 45.8% and 74.0% (P<0.05), and the elective nodal failure (ENF) rates were 4.2% and 11.1%, respectively. Kaplan-Meier analysis showed that the mean local-progression-free survival time was 11.0 and 15.0 months, and 1-year local-failure rates were 51.9% and 24.5% (P<0.05), while the median overall survival time was 13.0 and 15.0 months, respectively (P＝0.084). The 1-year survival rates were 55.7% and 72.5%,and 2-year survival rates were 0% and 19.9%. There was no significant difference among occurrences of radiation-associated complications. Conclusions Omitting elective nodal irradiation did not increase incidence of elective nodal failure. On the contrary, it decreased local failure rate by increasing prescription doses to the primary diseases and lymphadenopaphy. Thus it may further prolong patients' survival. |
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