| Dejian Pan,Biao Wang,Weibing Wang,Yuanwen Wu,Xijian Zhou,Donglin Wang. 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. Oncol Transl Med, 2014, 13: 299-304. |
| 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 |
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| KeyWord:gefitinib; γ-ray stereotactic body radiation therapy (SBRT); epidermal growth factor receptor (EGFR) mutations; senile; first-line regimen |
| Author Name | Affiliation | | Dejian Pan | Department of Oncology, 101st Hospital of PLA, Clinical Medical College of Jiangsu University, Wuxi 214044, China | | Biao Wang | Department of Oncology, 101st Hospital of PLA, Clinical Medical College of Jiangsu University, Wuxi 214045, China | | Weibing Wang | Department of Oncology, 101st Hospital of PLA, Clinical Medical College of Jiangsu University, Wuxi 214046, China | | Yuanwen Wu | Department of Oncology, 101st Hospital of PLA, Clinical Medical College of Jiangsu University, Wuxi 214047, China | | Xijian Zhou | Department of Oncology, 101st Hospital of PLA, Clinical Medical College of Jiangsu University, Wuxi 214048, China | | Donglin Wang | Department of Oncology, Affiliated Tongji Hospital, Tongji University, Shanghai 200065, China |
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| Abstract: |
| 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. |
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