Study Of Individualized Chemo-radiotherapy Of Non-small Cell Lung Cancer Guided By PET-CT

ObjectiveTo explore the effect and safety of individualized chemo-radiotherapy of non-small cell lung cancer guided by PET-CT.Materials and MethodsThe study was a prospective randomized controlled trial.17 NSCLC who met inclusion criteria were randomly divided into two groups(Group A: standard chemo-radiotherapy group;Group B: individualized chemo-radiotherapy group).Before treatment,all NSCLC underwent PET-CT.Group A underwent standard radiotherapy(DT 40 Gy,20 time/4 weeks)guided by CT,and during the 18 th of radiotherapy,treatment(DT 20 Gy,10time/2 weeks)was updated by contrast-enhanced CT.Group B underwent individualized radiotherapy(GTV 2.2-2.4Gy/time,PTV 2.0Gy/time,20 time/4 weeks)guided by PET-CT,and during the 18 th of radiotherapy,treatment(increased dose: 2.2-3.8Gy/time,PTV 2.0Gy,10 times/2 weeks)was updated by PET-CT.All NSCLC underwent chemotherapy after radiotherapy.Outcomes included OS,PFS,ORR and adverse events.Results1.There were 3 NSCLC who were dead in group A and 3 NSCLC in group B.Compared with group A,OS in group B was similar(539 days vs.318 days)but not non-significant trends(P>0.05).2.There were 3 PFS in group A and 2 PFS in group B.Compared with group A,PFS in group B was similar(33.71 days vs.238.67 days)but not non-significant trends(P>0.05).3.There were 2 PR and 4 SD in group A and 4 PR,6 SD and 1 PD in group A.Compared with group A,ORR in group B was similar(36.4% vs.33.3%)but not non-significant trends(P>0.05).4.There were 2 NSCLC with radiological pneumonia in group A and 3 NSCLC with radiological pneumonia in group B.Compared with group A,the risk of radiological pneumonia in group B was similar(36.4% vs.33.3%)but not non-significant trends(P>0.05).ConclusionThis study shows that individualized chemo-radiotherapy which guided by PET-CT may increase OS and PFS in NSCLC,but was not likely to improve ORR.Meanwhile individualized chemo-radiotherapy may also decrease risk of radiological pneumonia.Unluckily,it was certified by a multi-center large sample clinical trial in the future.