Efficacy Comparative Analysis Between Conventional Fractionation And Hypo-fractionation Radiotherapy On Non-small-cell Lung Cancer With Superior Vena Cava Syndrome

Objective: This study was to investigate the short-term efficacy, long-term efficacyand toxic side effects of conventional fractionation and hypo-fractionation treatment onNon small cell lung cancer with superior vena cava syndrome, analyze the correlativefactors and provide basis for clinical treatment.Methods:59cases of Non-small-cell lung cancer with SVCS from Dalian CentralHospital during2008to2012were analyzed retrospectively, among which33cases inconventional fractionation group and26cases in hypo-fractionation group. Both groupswere treated with6MV X-Ray,3D-CRT. The target zone includes superior vena cavaperipheral tumor, mediastinum, hilum and primary lesion. CF group was treated200cGyper time,5times a week, with a total dose of66Gy and BED of7920cGy; HF groupwas treated400cGy per time,3times a week, with a total dose of56Gy and BED of7840cGy. PTV was included in the isodose curve of90%. Efficacy analyses of bothgroups were compared. SPSS17.0software was used, measurement data using T teststesting method, count data using X2test, survival analysis using Kaplan-Meier Methodsand univariate analysis using Log-Rank test.Result:1.1week after radiotherapy, the symptom remission rate of HF group was69.2%while that of CF group was48.5%, the two groups had a significant difference, P＜0.05;2weeks after radiotherapy, the complete remission rate of HF group was80.8%while that of CF group was66.7%, difference was not statistically significant, P＞0.05.2. The major subsidiary reaction of the two groups were marrow and airwayresponse. The incidence of neutropenia were36.1%in CF group, and64.4%in HFgroup; the incidence of cough and short of breath were27.3%in CF group, and50.0%in HF group, difference was not statistically significant,,P>0.05. 3.The objective response rate of the two groups was67.8%,57.6%in CF group and80.8%in HF group. The effective rate of HF group was better than that of CF group, P＜0.05, which were statistically significant.4. One year survival rate was27.3%in CF group while15.4%in HF group, and thedifference was statistically significant, P<0.05. Two years of survival rate was6.1%inCF group while3.8%in HF group, and the difference was not statistically significant, P＞0.05. According to the survival curve, the survival rates of the two groups werefalling, as time went on. The CF group had a longer overall survival time than that ofHF group. However, it is not statistically significant, P=0.174＞0.05, in Log Rank(Mantel-Cox) test, which may be related to small sample size.Conclusion: The HF radiotherapy may rapidly alleviate the symptom of SVCS, hasa better short-term efficacy than CF radiotherapy. And no obvious increase of adversereaction. Treatment in clinical practice should be initiated according to individualdifferences of patients.