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Objective: The senile lung adenocarcinoma patients harboring an activating epidermal growth factor receptor(EGFR) mutation shows good and rapid response to EGFR tyrosine kinase inhibitors(TKIs). Whether gefitinib combined with γ-ray stereotactic body radiation therapy has better efficacy than gefitinib alone for senile lung adenocarcinoma patients with EGFR mutations as first-line regimen is still under investigation. Methods: The 42 senile lung adenocarcinoma patients with EGFR mutations were divided into 2 groups according to the therapy method. Group A was the 22 patients treated with gefitinib combined with γ-ray stereotactic body radiation therapy(SBRT). Group B was the 20 patients treated with gefitinib alone. All of the patients received gefitinib of 250 mg/d from the first day until disease progression or other reasons. The patients of Group A were treated with γ-ray stereotactic body radiation therapy from the second day. Radiation fields included the primary lesions and the integration of lymph nodes. Dose curve of this group was 50%–80%. Encircled dose was 4.0–6.5 Gy per fraction and the range of total dose was 40–52 Gy. We treated the patients 8–12 times and treated five times every week. Results: All the patients were examined by enhanced double helix CT at the second month. The tumor response rate(RR) of group A was 81.8%(18/22). Disease control rate(DCR) was 90.9%(20/22). The median overall survival(OS) was 24.2 months(range 8–58 months) and the progression-free survival(PFS) was 18.6 months. The overall 1-year survival rate was 72.3%(16/22) and 2-year survival rate was 54.5%(12/22). The main side effects included skin rash and diarrhea. The RR of group B was 50.0 %(10/20). DCR was 75.0%(15/20). OS was 17.4 months(range 6–32 months) and PFS was 12.1 months. The overall 1-year survival rate was 60.0%(12/20) and 2-year survival rate was 40.0%(8/20). The main side effects included skin rash and diarrhea. The group A who were treated with gefitinib combined with γ-ray stereotactic body radiation therapy had a higher short term therapeutic effects(RR) and long term therapeutic effects(OS) than group B who were treated with gefitinib alone respectively(81.8% vs 50.0%, P = 0.029 < 0.05, χ2 = 4.773 and 24.2 vs 17.4, P = 0.024 < 0.05, χ2 = 5.098). Conclusion: Gefitinib combined with γ-ray stereotactic body radiation therapy has better efficacy than gefitinib alone for senile lung adenocarcinoma patients with EGFR mutations as first-line regimen. The side affects are acceptable.
Objective: The senile lung adenocarcinoma patients harboring an activating epidermal growth factor receptor (EGFR) mutation shows good and rapid response to EGFR tyrosine kinase inhibitors (TKIs). Whether gefitinib combined with γ-ray stereotactic body radiation therapy has better efficacy than gefitinib alone for senile lung adenocarcinoma patients with EGFR mutations as first-line regimen is still under investigation. Methods: The 42 senile lung adenocarcinoma patients with EGFR mutations were divided into 2 groups according to the therapy method. Group A was the 22 patients treated with gefitinib combined with G-ray stereotactic body radiation therapy (SBRT). Group B was the 20 patients treated with gefitinib alone. All of the patients received gefitinib of 250 mg / d from the first day until disease progression or other reasons. The patients of Group A were treated with γ-ray stereotactic body radiation therapy from the second day. Radiation fields included the primary lesions and th Dose curve of this group was 50% -80%. Encircled dose was 4.0-6.5 Gy per fraction and the range of total dose was 40-52 Gy. We treated the patients 8-12 times and treated five The control response rate (RR) of group A was 81.8% (18/22). Disease control rate (DCR) was 90.9% ( The median overall survival (OS) was 24.2 months (range 8-58 months) and the progression-free survival (PFS) was 18.6 months. The overall 1-year survival rate was 72.3% (16/22) The main side effects included skin rash and diarrhea. The RR of group B was 50.0% (10/20). DCR was 75.0% (15/20). OS The overall 1-year survival rate was 60.0% (12/20) and 2-year survival rate was 40.0% (8/20). The main side effects were 17.4 months (range 6-32 months) and PFS was 12.1 months. included skin rash and diarrhea. The group A who were treated with g efitinib combined with γ-ray stereotactic body radiation therapy had a higher short term therapeutic effects (RR) and long term therapeutic effects (OS) than group B who were treated with gefitinib alone (81.8% vs 50.0%, P = 0.029 < χ2 = 4.773 and 24.2 vs 17.4, P = 0.024 <0.05, χ2 = 5.098). Conclusion: Gefitinib combined with γ-ray stereotactic body radiation therapy has better efficacy than gefitinib alone for senile lung adenocarcinoma patients with EGFR mutations as first-line regimen The side affects are acceptable.