3-dimensional conformal radiotherapy and paclitaxel radiosensitization combined with chemotherapy on locally advanced non-small cell lung cancer

Objective: To evaluate the efficacy and side-effect of 3-Dimensional conformal radiotherapy (3-DCRT) and paclitaxel radiosensitization combined with or without chemotherapy on locally advanced non-small cell lung cancer (NSCLC). Methods: Fifty cases of stage III A and III B NSCLC were treated with 3-DCRT and paclitaxel radiosensitization, including 27 patients combined with chemotherapy(group 1) and 23 patients without chemotherapy(group 2). They were given chest 3-DCRT at 3-4 Gy/d for 5 d/week till a total dose of 60-70 Gy within 4-5 weeks. Before fractionated irradiation weekly, paclitaxel chemotherapy was administered at first with the dose of 30-40 mg/m2 for 3 h by infusion. The chemotherapy regimen is paclitaxel 135 mg/m2 by intravenous infusion at days 1, 8 and cisplatin 75 mg/m2 by intravenous infusion at days 2-4. The treatment was repeated every 28 days, up to 3-6 courses. Results: The overall response rates (CR + PR) in group 1 and group 2 were 88.8% and 60.8%, respectively (P<0.05). The median survival time were 21 and 16 months in respectively. The 1-, 2-, and 3-year survival rates were 74.1%, 40.7%, 19.1%, and 64.7%, 20%, 10%, respectively (P<0.05). The main toxicities of granulo-cytopenia were 85.2% and 43.5%, respectively (P<0.05). Conclusions: Weekly low dosage of paclitaxel with concurrent 3-DCRT combined with chemotherapy might be tolerable and promising in the treatment of locally advanced NSCLC. (authors)