Clinical Study On SBRT And IMRT For Patients With Early Non-small Cell Lung Cancer

Clinical study on SBRT and IMRT for patients with early non-small cell lung cancerObjective:To compare the effect of accelerated hypofractionation in stereotactic body radiation therapy(SBRT) and conventional fractionation in intensity modulated radiation therapy (IMRT) for early non-small cell lung cancer(NSCLC).Methods:From January2009to December2011, sixty-four patients with stage I and II NSCLC were randomized into two group:accelerated hypofractionation(AHF) by40～50Gy/10f/2～3w,5f/w(50%～70%dosage curve), and conventional group (CF) by56～66Gy/28～33f/5～7w(90%dosage curve).Elective nodel irradiation was not performed in either group. To observe the overall response rates (CR+PR) and the overall of1-,2-local control rate and the overall of1-,2-survival rate in two groups.To observe the toxicities of radiation, and analysis the cause of failure and death. The overall response was evaluated by RECIST standard, and the accute toxicities of radiation was evaluated by RTOG standard. Survival was caculated by Kaplan-meier method. The difference of survival between the two group was evaluated by logrank test. The difference in response among two group was evaluated by X2test.Results:For AHF group and CF group, the overall response rates (CR+PR) were93.8%和68.6%(P=0.037), respectively. The1-,2-year overall survival rates were87.5%and71.9%,81.2%and56.3%, the median survival time was24months and18months (P=0.001), respectively. The local recurrence rates of AHF and CF groups were15.6%and37.5%and distant metastasis rates were9.4%and28.1%(P<0.05), respectively.The difference of radiation toxicity was not significant between the two groups (P>0.05).Conclusion:The overall response rates (CR+PR) and the overall of1-,2-survival rate of the stereotactic body radiation therapy(SBRT) is improved by accelerated hypofractionation in stereotactic body radiation therapy (SBRT) for early NSCLC. The incidence of radiation toxicities were similar.