Observation of short-term clinical efficacy and adverse reactions with stereotactic radiotherapy in locally recurrent non-small cell lung cancer

Objective To investigate the short-term clinical efficacy and adverse reactions of stereotactic radiotherapy (SRT) in the treatment of locally recurrent non-small cell lung cancer (NSCLC). Methods Clinical data of 120 cases of recurrent NSCLC after radiotherapy admitted to our hospital from October 2009 to October 2015 were retrospectively analyzed. SRT was adopted for further radiotherapy. The prescription dose was 50% dose curve surrounding the target area. The total dose was 40-50 Gy, with a single dose of 4-5 Gy for 8-12 times. The chest CT was re-examined every 2 months after radiotherapy. The short-term clinical efficacy and adverse reactions were evaluated. The changes of Karnofsky performance score (KPS) and quality of life (QOL) were recorded before and after radiotherapy. Results One patient terminated the radiotherapy due to grade 3 acute radiation-induced pneumonia, 25 patients (21.0%) obtained complete remission (CR), 61 cases (51.3%) of partial remission (PR), 19 cases (16.0%) of stable disease (SD), 14 cases (11.8%) of progress disease (PD), 86 cases (72.3%) of objective remission rate (CR+ PR), and 105 cases (88.2%) of disease control (CR+ PR+ SD), respectively. Thirty-one patients experienced radiation-induced pneumonia, 23 cases of radiation-induced myelosuppression and 1 case of acute radiation-induced heart injury. All these adverse reactions were mitigated after symptomatic treatment. The KPS was significantly increased from 68.16±15.22 before SRT to 78.39±11.50 after SRT (P<0.05). The QOL was considerably elevated from 27.58±5.37 prior to SRT to 38.16±8.39 following SRT (P<0.01). Conclusion SRT is an efficacious and safe treatment of locally recurrent NSCLC, which yields controllable and tolerable adverse reactions and enhances the QOL of patients. Key words: Lung neoplasm, local recurrence/stereotactic radiotherapy; Short-term efficacy; Adverse reaction