The study on importance of three-dimensional radiotherapy for elderly patients with stage Ⅳ non small cell lung cancer
10.3760/cma.j.issn.1004-4221.2012.06.006
- VernacularTitle:老年Ⅳ期非小细胞肺癌三维放疗重要性研究
- Author:
Bo ZHANG
;
Bing LU
;
Shengfa SU
;
Yinxiang HU
;
Weiwei OUYANG
;
Huiqin LI
;
Zhu MA
;
Jinhua LONG
- Publication Type:Journal Article
- Keywords:
Carcinoma,non-small cell lung/concurrent chemoradiotherapy;
Radiotherapy,three-dimensional;
Prognosis;
Elderly
- From:
Chinese Journal of Radiation Oncology
2012;(6):504-507
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the importance of three-dimensional radiotherapy for elderly patients of stage Ⅳ non-small cell lung cancer (NSCLC).Methods Comparing with treatment outcome of ≥65 years 67 patients and < 65 years 134 patients using concurrent chemotherapy and thoracic threedimensional radiotherapy during 2003 to 2010 years.Survival analysis was taken by Kaplan-Meier method.The multivariate prognosis was analyzed by Cox model.Results The follow-up was 97.8%.The percentage of ≥65 years and < 65 years patients accepted with concurrent 4-5 cycles chemotherapy were 30% and 55%,and with 42% and 49% patients with radiotherapy ≥63 Gy.The median survival time (MST) were 17 months and 14 months (x2 =0.76,P =0.384) for ≥65 years and < 65 years patients accepted with concurrent 4-5 cycles chemotherapy concurrent ≥63 Gy radiotherapy respectively.The MST and 1-,2-,3year overall survival rate were 17 months and 8 months,65% and 23%,30% and 13%,24% and 9%(x2 =7.90,P =0.005) for whole groups patients treated with chemotherapy concurrent ≥63 Gy and < 63 Gy radiotherapy.And the MST of patients ≥ 63 Gy was significantly longer than those with < 63 Gy either concurrent chemotherapy any cycles (x2 =9.54,P =0.023).The MST were 14 months and 8 months (x2 =1.82,P=0.178),17 months and 17 months (x2 =0.47,P=0.492) for ≥ 65 years and ≥ 63 Gy radiotherapy patients accepted with concurrent 4-5 cycles and 2-3 cycles chemotherapy concurrent respectively.Multivariate analysis showed local response (β =0.600,P =0.003) and numbers of tumor metastasis (β =0.670,P =0.040) were independent factors for survival.Conclusions For a part of elderly patients of stage Ⅳ NSCLC,concurrent chemotherapy and thoracic three-dimensional radiotherapy can prolong survival time with acceptable toxicity.Perhaps radiotherapy is more important.