[Escalated hyperfractionated accelerated radiation therapy combined with chemotherapy for stage IIIB XXXX ].

@entity1 @entity137 @entity5 @entity1149 @entity6937
BACKGROUND: To evaluate the therapeutic effect and acute side-effect of escalated hyperfractionated accelerated radiation therapy (EHART) combined with chemotherapy for stage IIIB @entity1149 ( @entity1149 ). METHODS: From Aug. 1998 to Aug. 2001, a prospective trial for @entity1149 was carried out in 112 @entity1 with stage IIIB. These @entity1 were nonrandomly divided into 2 groups: conventional fractionated radiation therapy group (CFRT 65 cases) and EHART group (47 cases). The CFRT @entity1 were treated by 1.8-2 Gy/fraction per day, 5 treatment days per week; the total doses received in center of @entity5 were 54-70 Gy /27-40 fractions/37-85 days, the median was 60 Gy/30 factions/43 days. The EHART @entity1 were treated by escalated doses: In the first and second weeks, 1.2 Gy/fraction twice a day was given, then 1.3 Gy , 1.4 Gy , and 1.5 Gy from third to fifth weeks respectively, twice fractions a day (over 6 hours interval), 5 treatment days each week, the total doses were 60-66 Gy/46-50 fractions/30-45 days, the median was 66 Gy /50 fractions/34 days. Radiation fields just covered the @entity5 mass which were determined by thoracic CT with 1.5 cm margins. A total of 4-6 cycles chemotherapy with MVP regimen mostly was delivered before (1-2 cycles) and after (3-5 cycles) radiotherapy. Each @entity1 was followed up for 1 year. RESULTS: Seven cases were excluded from EHART, twelve from CFRT. There were 93 @entity1 to be evaluated. The immediate response rate of @entity5 by EHART and CFRT was 72.5% and 64.2% respectively (Chi-square=1.02, P=0.346). The 1-year survival rate was 60.0% and 47.2% respectively (Chi-square=2.56, P=0.107), and the local control rate was 67.5% and 52.8% respectively (Chi-square=3.01, P=0.085). The incidence and degree of @entity6937 in EHART were more severe than that in CFRT (Chi-square=5.02, P=0.025). CONCLUSIONS: The treatment effect by EHART for stage IIIB @entity1149 is encouraging and its @entity137 could be tolerated by most of @entity1 . It is worthy of further study on survival rate and late complications in long term.
