Clinical study of three-dimensional conformal radiotherapy combined with concurrent and sequential gemcitabine chemotherapy for stage III non-small cell lung cancer in elderly patients

OBJECTIVE:To observe the efficacy and toxicity of three-dimensional conformal radiotherapy(3D-CRT) combined with concurrent and sequential gemcitabine chemotherapy for locally advanced non-small cell lung cancer(NSCLC) in elderly patients.METHODS:Eighty five patients(65 years)with stage Ⅲ NSCLC were enrolled and divided into three-dimensional conformal radiotherapy(3D-CRT) group(43 cases) and two-dimensional radiotherapy(2D-RT) group(42 cases).All patients received gemcitabine at 400 mg/(m2·wk) over 7 weeks concurrently combined with radiotherapy to 60～70 Gy in 30～35 fractions(6/15 MV X ray,2 Gy/f evenyday,5 f/week) and sequential gemcitabine(2 weeks after radiotherapy) at 1 000 mg/(m2·wk) d1 and d8 on days 1 and 8 of a 3-week cycle for 2～3 cycles.RESULTS:The overall response rate and complete response rate of primary tumor and mediastinum metastatic node were 86.1% and 25.6% in trial group,and 66.7% and 9.5% in control group(P=0.035).There was a overall response advantage for squamous cell carcinoma over adenocarcinoma(87.5% vs 66.7%)(P=0.021).Median overall survival time was 18.2 and 14.2 months for trial group and control group,respectively.The 1-and 2-year survival rates were 70.5%,35.5% in the trial group and 55.6%,26.6% in the control group,respectively(P were 0.065 and 0.075).CONCLSIONS: It results in better response and survival time,with lower rates of more than grade 3 acute radiation-esophagitis and radiation-pneumonia.Also there is better response for squamous cell carcinoma than adenocarcinoma.