Abstract:
Objective To investigate the efficacy and prognostic factors of clinical stage ⅢA(N2) non-smallcell lung cancer (NSCLC) patients treated with 3-dimensional conformal or intensity-modulated radiotherapy.
Methods From January 2010 to December 2011, the data of 113 patients with clinical stage ⅢA(N2) NSCLC at the Fourth Hospital of Hebei Medical University were analyzed. The efficacy and prognosticfactors were observed.
Results The overall 1-, 2- and 3-year overall survival (OS) of entire cohort were70.5%, 39.3% and 23.8%, respectively. The overall 1-, 2- and 3-year local control rates(LCR) of entirecohort were 76.6%, 54.5% and 47.9%, respectively. The overall 1-, 2- and 3-year disease-free survival (DFS)of entire cohort were 50.6%, 25.3% and 18.7%, respectively. The univariate analysis showed that gender,ECOG performance status, chemotherapy and tumor response were associated with OS; T stage, GTV size,chemotherapy and tumor response were associated with LCR. Multivariate analysis revealed that gender,ECOG performance status, chemotherapy and tumor response were the independent factors for predicting theOS; GTV size, chemotherapy and tumor response were the independent factors for predicting the LCR. There were 13.3% (15/113) patients with grade≥2 acute radiation-related pneumonitis after radiotherapy; there were 5.3% (6/113) patients with grade≥2 acute radiation esophagitis; there were 17.7% (20/113) patients with grade≥2 hematologic toxicity.
Conclusion Radiotherapy may be effective in the treatment of clinicalstage ⅢA(N2) NSCLC and side-effect can be tolerated. Gender, ECOG performance status, GTV size,chemotherapy and tumor response may be the independent risk factors for predicting the prognosis.