Clinical Effects of Accelerator Linear Plus Gamma Knife Radiotherapy Combined with Concurrent DP Regimen Chemotherapy for Locally Advanced Non-small Cell Lung Cancer

ObjectiveTo investigate the short-term effects and adverse reactions of accelerator linear and gamma knife radiotherapy combined with concurrent DP chemotherapy for locally advanced non-small cell lung cancer(NSCLC). MethodsNinety six patients with locally advanced NSCLC were randomly assigned to three treatment arms. In group A, patients received accelerator linear and gamma knife radiotherapy combined with concurrent 4 cycles of DP chemotherapy. The treatment plans were accelerator linear using 6MV x-rays by 50Gy/25F,and then gamma knife radiotherapy by 20Gy/4F, once every other day. In group B, patients received accelerator linear radiotherapy by (60~66)Gy/(30~33)F with concurrent 4 cycles of DP chemotherapy. In group C, patients received accelerator linear radiotherapy using 6MV x-rays by (60～66)Gy/(30～33)F after 2 cycles of DP chemotherapy, and then received another 2 cycles of DP chemotherapy. ResultsNinety patients finished the treatment. The overall response rates of the three groups were 87.1%, 86.7% and 62.1%, respectively (PAB=1.000, PAC=0.025, PBC=0.030). The overall 1-year survival rates of the three groups were 77.4%, 73.3% and 72.4%, respectively(PAB=0.711, PAC=0.655, PBC=0.937). The adverse reactions were radiation pneumonitis, radiation esophagitis, gastrointestinal effects and myelosuppression. The incidence rates of radiation pneumonitis more than gradel were 32.3%, 60.0% and 20.7%, respectively (PAB=0.030, PAC=0.311, PBC=0.002). The incidence rates of myelosuppression over gradel were 61.3%,66.7% and 31.0%,respectively(PAB=0.662,PAC=0.019,PBC=0.006). ConclusionThe combination of accelerator linear plus gamma knife radiotherapy with concurrent DP chemotherapy can improve the short-term effects in locally advanced NSCLC patients with acceptable toxicities although the long-term effects and toxicities need to be further researched.