Prognostic factors of three-dimensional conformal radiotherapy for stage lⅢ non-small cell lung cancer patients aged 70 and over / 中华老年医学杂志

ABSTRACT

Objective To assess the therapeutic efficacy and prognostic factors in elderly patients with stage Ⅲ non-small cell lung cancer (NSCLC) after three-dimensional conformal radiotherapy (3DCRT).Methods A retrospective analysis of 124 stage Ⅲ NSCLC patients aged 70 or over who had received treatment with 3DCRT was conducted retrospectively in this study.There were 99 male and 25 female patients,with a median age of 74 years(range:70-84).The median dose was 60 Gy(range 50-72 Gy).Eighty-three patients were treated with radiotherapy alone,27 with sequential and 14 with concurrent radiochemotherapy.Results The end date of follow-up was August 30,2013.After 3DCRT,the 1-,3-and 5-year overall survival (OS) were 61.1％,23.8％ and13.2 ％,respectively,and the median survival time was 18 months.Univariate analysis revealed that gender,obstructive pneumonia,dosage,method of therapy and immediate effect were related to OS(x2 =3.957,6.398,7.147,12.307 and 11.035,respectively;P=0.047,0.011,0.008,0.002 and 0.001,respectively).Multi-variable analysis indicated that age,gender,obstructive pneumonia,dosage and method of therapy were independent prognostic factors for OS.The OS time was longer inpatients who were female,aged over 75,with no obstructive pneumonia or dosage≥ 60 Gy.Compared with radiotherapy alone,sequential radiochemotherapy increased OS while concurrent radiochemotherapy decreased OS.Conclusions Sex,age,obstructive pneumonia and dosage affect the survival of elderly stage Ⅲ NSCLC patients treated with three-dimensional conformal radiotherapy.Concurrent radiochemotherapy should be considered with caution