Abstract
Objective: To evaluate the significance of adjuvant chemotherapy and radiotherapy (Gamma-knife) in the elderly patients with retreated advance lung cancer. Methods 83 patients (age 50 to 81 years) with retreating advanced (III/IV stage) lung cancer were divided into three groups according to patients received treating by different methods. The cases were treated by synchronous chemo-radiotherapy (A group), sequentially chemo-radiotherapy (B group) and continuous systematized chemotherapy alone (C group). The systemic 3-dimensional orientation apparatus was used in radiotherapy. The chemotherapy regimen in combined radiotherapy was given by common first line regimen on lung cancer. The regimen of chemotherapy combated with whole body hyperthermia by using micro-wave on abodeman about 2 or 3 line was used in C group only. Results: The overall responses rates (RR) of A, B and C groups were 17.1%, 11.5% and 31.8%, but it was non-significance difference (P > 0.05). Overall responses rates (RR) of III and IV stage groups were 18.2% and 20.0%. The average overall survival time (OS) and median survival time (MST) of the patients treated by chemotherapy (C group) were highest about 14.2 and 9.3 months (respectively at A group 6.7 and 6.0 months. P < 0.01), in which B group was longer than A group (P < 0.05), and 95.5% CI value was not overlap. The total survival time of postoperative patients was longer in the various groups by different treated than that in non-operations. Conclusion: The rates (RR) of III and IV stage groups were non-significance difference. The higher of ORR, OS and MST in a few patients of re-treated advanced lung cancer was presented in case with treated by continuous system chemotherapy. There were survival superiority in initial postoperative patients groups by different treated. It is a profitable and effect treatment that the pure reasonable systemic chemotherapy was used for elderly case with advanced retreated lung cancer.
Highlights
The retreating to elder patients with advanced lung cancer is a problems that often needs to be faced in clinical practice
Eighty-three patients, median age 67.3 year (50 to 81 years), with retreating advanced (III/IV stage) lung cancer were divided into three groups according to patients received treating by different methods. 35 cases were treated by synchronous chemo-radiotherapy. 26 cases were treated by sequentially chemo-radiotherapy and 22 cases were treated by continuous systematized chemotherapy alone
The higher effective rate was presented in stage III case with synchronous chemo-radiotherapy (23.1%), and in stage IV with continuous systematized chemotherapy alone (38.5%), but overall responses rates (RR) of III/IV stage groups was non-significance difference (18.2% and 20.0%)
Summary
The retreating to elder patients with advanced lung cancer is a problems that often needs to be faced in clinical practice. A number of studies have shown that appropriately chemotherapy or radiotherapy is better than the best supportive care. Due to the special physiological function of old patients, it was considered that how to choose the best treatment for the patients. For patients treated again, at present this kind of research is not much. It is object about the paper to investigate the effect and significance of adjuvant chemotherapy with hyperthermia and radiotherapy (Gamma-knife) in the treatment of elderly patients with retreated advance lung cancer
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