Involved-field Radiation Therapy for Patients with Stage III Non-small-cell Lung Cancer: Early Results of Hypofractionated Involved-field Radiation Therapy

摘要

Objective. To evaluate the outcomes after treating patients with stage III non-small-cell lung cancer (NSCLC) using involved-field radiation therapy (IFRT) without elective nodal irradiation and to evaluate the effects of hypofractionated IFRT. Methods. From December 2004 to November 2015, 51 patients with advanced NSCLC underwent IFRT. Of these, 45 patients were enrolled and evaluated. The median age was 69 years (range, 50-89 years), and 42 patients were men and 3 women. Eleven patients (24.4%) presented with adenocarcinoma, 30 (66.7%) with squamous cell carcinoma, and 4 (8.9%) with other types. Twenty-four (53.3%) had stage IIIA and 21 (46.7%) had stage IIIB. In patients treated by conventional IFRT, normal fractionation was used (2 Gy/fraction), and the total prescribed dose ranged from 60 to 66 Gy. In patients treated by hypofractionated IFRT, 2.5 Gy/fraction was used, and the total prescribed dose ranged from 65 to 70 Gy. Results. The 1- and 2-year overall survival rates were 78.4% and 53.7% , respectively. The 1- and 2-year local control rates were 72.2% and 57.7%, respectively. The patients in the conventional IFRT group had a 1-year local control rate of 61.2% and a 2-year local control rate of 47.6%, while the patients in the hypofractionated IFRT group achieved higher local control rates of 87.1% and 72.5%, respectively (P = 0.0465). Conclusions. IFRT for patients with stage III NSCLC is feasible, and the incidence of elective nodal failure was low. Hypofractionated IFRT may therefore contribute to improvements in local control and overall survival.