Kang Ki Mun, Jeong Bae Kwon, Ha In Bong, Chai Gyu Young, Lee Gyeong Won, Kim Hoon Gu, Kang Jung Hoon, Lee Won Seob, Kang Myoung Hee
Department of Radiation Oncology, Gyeongsang National University School of Medicine, Jinju, Korea. ; Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea.
Radiat Oncol J. 2012 Sep;30(3):140-5. doi: 10.3857/roj.2012.30.3.140. Epub 2012 Sep 30.
Combined chemoradiotherapy is standard management for locally advanced non-small cell lung cancer (LA-NSCLC), but standard treatment for elderly patients with LA-NSCLC has not been confirmed yet. We evaluated the feasibility and efficacy of concurrent chemoradiotherapy (CCRT) for elderly patients with LA-NSCLC.
Among patients older than 65 years with LA-NSCLC, 36 patients, who underwent CCRT were retrospectively analyzed. Chemotherapy was administered 3-5 times with 4 weeks interval during radiotherapy. Thoracic radiotherapy was delivered to the primary mass and regional lymph nodes. Total dose of 54-59.4 Gy (median, 59.4 Gy) in daily 1.8 Gy fractions and 5 fractions per week.
Regarding the response to treatment, complete response, partial response, and no response were shown in 16.7%, 66.7%, and 13.9%, respectively. The 1- and 2-year overall survival (OS) rates were 58.2% and 31.2%, respectively, and the median survival was 15 months. The 1- and 2-year progression-free survivals (PFS) were 41.2% and 19.5%, respectively, and the median PFS was 10 months. Regarding to the toxicity developed after CCRT, pneumonitis and esophagitis with grade 3 or higher were observed in 13.9% (5 patients) and 11.1% (4 patients), respectively. Treatment-related death was not observed.
The treatment-related toxicity as esophagitis and pneumonitis were noticeably lower when was compared with the previously reported results, and the survival rate was higher than radiotherapy alone. The results indicate that CCRT is an effective in terms of survival and treatment related toxicity for elderly patients over 65 years old with LA-NSCLC.
放化疗联合是局部晚期非小细胞肺癌（LA-NSCLC）的标准治疗方法，但老年LA-NSCLC患者的标准治疗方法尚未得到证实。我们评估了同步放化疗（CCRT）用于老年LA-NSCLC患者的可行性和疗效。
对年龄大于65岁的LA-NSCLC患者中接受CCRT的36例患者进行回顾性分析。放疗期间每4周进行3-5次化疗。对原发灶和区域淋巴结进行胸部放疗。总剂量为54-59.4 Gy（中位数为59.4 Gy），每日1.8 Gy，每周5次。
关于治疗反应，完全缓解、部分缓解和无反应分别为16.7%、66.7%和13.9%。1年和2年总生存率（OS）分别为58.2%和31.2%，中位生存期为15个月。1年和2年无进展生存率（PFS）分别为41.2%和19.5%，中位PFS为10个月。关于CCRT后出现的毒性，3级或更高等级的肺炎和食管炎分别在13.9%（5例患者）和11.1%（4例患者）中观察到。未观察到与治疗相关的死亡。
与先前报道的结果相比，食管炎和肺炎等与治疗相关的毒性明显较低，且生存率高于单纯放疗。结果表明，CCRT对于65岁以上的老年LA-NSCLC患者在生存和治疗相关毒性方面是有效的。
