X. H. Yu et al.
Keywords
Elderly Patients, Chemotherapy, Combined Radiotherapy, Lung Cancer
1. Background
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. Especially 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.
2. Clinical Material and Methods
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 (group A). 26 cases were treated by sequentially chemo-radiothe-
rapy (group B) and 22 cases were treated by continuous systematized chemotherapy alone (group C). (see Table
1). All patients were selected for inclusion in study after the initial treatment stoped 2 - 3 months. The systemic
3-dimensional orientation apparatus was used in radiotherapy. The total dose of 35-55GY was given in syn-
chronous or sequential chemo-radiotherapy. The chemotherapy regimen in combined radiotherapy was given by
common first line regimen on lung cancer. (NSCLC: NVB25 mg/m2 d1, 8, GEM 0 .8 - 1.0/m2 d1, 8, DDP 40 mg
d1-3 or D DP 20 mg d1-5. SCLC: CBP AUC = 5, VP16 0.1/m2. q21d). The part chemotherapy combated with
whole body hyperthermia by using micr o-wave on abodeman in temperature 40˚C - 42˚C for 1 - 2 hours. The
regimen of chemotherapy about 2 or 3 line was used in C group only. Drugs was used at Taxol (Squibb US, Co)
175 mg/ m2 d1, or Docertacel (Aventis Pharma, SA, Co) 70 - 80 mg/m2, d1; Pemetrexed (Lilly France SAS, Co)
500 mg/m2, d1.). The responce rate was statistically based on RECIST (WHO) method.
Statistical analysis The categorical variables percent date were compared between the two groups by using the
inpendent X2 test. Continuous data were compared between two groups by using independent t test. A two-tailed
P value of < 0.05 was considered statistically significant. Survival was calculated by using the Kaplan-Meier
method and compared by using the log-rank test. The Kaplan-meier curve was used to exhibit survival time.
3. Results
1) The overall responses rates (RR) of A, B and C groups were 17.1%, 11.5% and 31.8%, but it was non-sig-
nificance difference respectively at three group (P > 0.05). The higher effective rate was presented in stage III
case with synchronous chemo-radiotherapy (23.1%), and in stage IV with continuous systematized chemothera-
py alone (38.5%), but overall responses rates (RR) of III/IV stage groups was non-significance difference (18.2%
and 20.0%) (see Table 2).
2) The average overall survival time (OS) and median survival time (MST) of the patients treated by chemo-
Table 1. The general state of the patients with cancer on different treating groups.
Groups Cases SEX Mid-age Stage (%) PS (%)
M F III IV ≤2 ≥3
group A 35 23 12 54.6 13 (37.1) 22 (62.8)* 25 (71.4) 10 (28.6*)
group B 26 20 6 51.2 11 (42.3) 15 (57.7) 16 (61.5) 10 (38.5)
group C 22 13 9 56.5 9 (40.9) 14 (63.7)* 14 (63.7) 8 (36.3)
*P > 0.05.
