Abstract
PurposeWe conduct this study to compare the efficacy and toxicity of intensity-modulated radiotherapy (IMRT) concurrent weekly nedaplatin (NDP) versus IMRT alone in the stage III/IV non-surgical elderly patients with non-small-cell lung cancer (NSCLC).Methods117 patients were enrolled into our study. The patients were assigned into two different groups: radiotherapy (RT) group and chemoradiotherapy (CRT) group. Patients in RT group were treated with IMRT at a single daily dose of 2 Gy for 5 days per week, totally 52–66 Gy. The CRT group, IMRT concurrent weekly NDP at a dose of 25 mg/m2.ResultsIn CRT group, the median survival was 11.0 months (95% confidence interval [CI], 8.894–13.106 months) and in RT group, it was 7.0 months (95% CI 5.771–8.229 months). The 1-year, 2-year, 3-year, survival rates in the combined treatment arm were higher than the radiation therapy arm (46.8 vs 25.9%, 25.1 vs 11.8%, 14.7 vs 8.0%; p < 0.001). The Cox’s multiple regression analysis showed that CRT had significantly better overall survival than RT (HR 0.523; 95.0% CI 0.338–0.807; p = 0.003). The objective response rate provided that 73.3% treated with CRT compared with 51.1% (p = 0.018) received RT alone. Of the hematologic toxicities, leukocytes (35.0 vs 0%; p < 0.001), neutrophils (33.3 vs 0%; p < 0.001) were significantly more common in the CRT group than the RT group.ConclusionsWe first discovered that NDP concurrent IMRT for treating stage III/IV non-surgical elderly patients with NSCLC was good curative effect of better objective response rate and well-tolerated. However, within the low number of patients, only stage IV gained a survival benefit.
Highlights
Lung cancer is a major cause of tumor related mortality and the most common malignancy among people in most countries [1]
We first discovered that NDP concurrent intensity-modulated radiotherapy (IMRT) for treating stage III/IV non-surgical elderly patients with nonsmall-cell lung cancer (NSCLC) was good curative effect of better objective response rate and well-tolerated
The elderly patient is a special group regarded as 60 years or older in epidemiology according to their poorer body status, increased appearance of chronic disease complications, insensitive to therapy reaction [4]
Summary
Lung cancer is a major cause of tumor related mortality and the most common malignancy among people in most countries [1]. Of all cases of lung cancer, non-small-cell lung cancer (NSCLC) accounts for approximately 80% [2, 3]. There has been a significant increase in the occurring of NSCLC, with higher life expectancy worldwide, due to the relative accumulated increase in danger of tumor with age. Hurria and Siegel [5, 6] displayed that the incidence of NSCLC in elderly patients was high, in addition, the morbidity and mortality rates of patients-older than 60 years included 50% in patients-age range from 65 to 70 years and 30–40% of patients-older which than 70 years were higher. Except for patients who are susceptible to surgical resection, presently, most elderly NSCLC patients with locally or regionally advanced stage [7], at which the tumor is unresectable
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