ABSTRACT
Objective To evaluate the short -term efficacy and long-term efficacy of thoracic radiotherapy combined with gefitinib in the treatment of elderly patients with advanced non -small cell lung cancer . Methods From October 2012 to October 2015 , 120 elderly patients with advanced non -small cell lung cancer confirmed by histopathology as adenocarcinoma in the Third People's Hospital of Linyi were selected .Using envelope method,the patients were randomly divided into observation group and control group ,with 60 cases in each group .In the observation group ,IMRT was performed on pulmonary lesions ,and 125 mg of gefitinib was also given orally .The control group received IMRT .All patients were followed up , and the short -term efficacy , quality of life and the incidence of side effects in the two groups were observed .Results In terms of short-term efficacy,the RR of the observation group and the control group was 83.3％ vs.50.0％(χ2 =9.16,P=0.001),the disease control rate (DCR) of the observation group and the control group was 100.0％ vs.83.3％(χ2 =6.48,P=0.003),the PD of the observation group and the control group was 16.7％ vs.0.0％(χ2 =8.16, P =0.001 ).At 3 months after radiotherapy,the RR,DCR and PD of the observation group and the control group were 86.7％ vs.50.0％(χ2 =9.86,P=0.001),100.0％ vs.76.7％(χ2 =7.42,P=0.003),23.3％ vs.0.0％(χ2 =11.24,P=0.000).One year after radiotherapy,the RR of the observation group and the control group was 73.3％ vs.33.3％(χ2 =11.16, P=0.000),the DCR of the observation group and the control group was 54.0％vs.60.0％(χ2 =8.48,P=0.001), the PD of the observation group and the control group was 10.0％ vs.40.0％(χ2 =9.48,P=0.001).There was statistically significant difference between the two groups (P<0.05).As to the long-term efficacy,the progression-free survival (PFS) of the observation group and the control group was (17.64 ±1.86) months vs.(13.26 ± 1.82) months (t=7.28,P =0.000);overall survival (OS) was (26.16 ±2.14) months vs.(17.82 ± 2.02) months (t=10.62,P=0.000).The difference was statistically significant (P<0.05).The quality of life of the patients in the observation group was significantly better than that in the control group at 3 months,1 year and 2 years after radiotherapy (P <0.05).There was no statistically significant difference between the two groups in leukopenia,thrombocytopenia, anemia, esophagitis, radiation pneumonitis, gastrointestinal reaction, rash and other adverse reactions(all P >0.05).Conclusion Radiotherapy combined with gefitinib in the treatment of elderly patients with advanced non-small cell lung cancer has better short -term and long-term efficacy ,it can significantly improve the patients ' efficacy and DCR , prolong the patients ' disease PFS time and OS time , improve patients ' quality of life.And did not increase adverse reactions ,it is worthy of clinical application .