The influence of concurrent chemoradiotherapy on survival for patients of different ages with stage IVnon-small cell lung cancer——reanalysis of two prospective studies

Objective To analyze the survival and toxicity after concurrent chemoradiotherapy in patients of different ages with stage Ⅳ non-small cell lung cancer (NSCLC). Methods Clinical data of 282 NSCLC patients in two prospective studies were retrospectively analyzed, who completed the protocol (at least 2 cycles of chemotherapy and thoracic radiation doses of ≥36 Gy). Among them, 44 patients were assigned into in the young group (≤ 45 years old), 161 patients in the middle-age group (46-64 years old) and 77 patients in the elderly group (≥ 65 years old). The clinical characteristics of patients among different groups were analyzed by χ2 test. The overall survival (OS) was calculated by Kaplan-Meier method. Stratified analysis was performed by Log-rank test. Multi-factor prognosis analysis was conducted by Cox’s proportional hazards regression model. Results The incidence of NSCLC in the male patients in the elderly group was higher than that in the middle-age and young groups. The 1-, 2-, 3-and 5-year OS did not significantly differ among different groups (P=0.810). The OS did not significantly differ among patients of the same gender, pathological type, T stage, N stage, metastasis status, same chemotherapy cycle, primary tumor dose and comprehensive treatment and short-term response (all P>0.05). The incidence of adverse events did not considerably differ among different groups. Multivariate analysis demonstrated that age was not an independent factor for survival (P>0.05). Conclusion Patients of different ages with stage Ⅳ NSCLC obtain similar survival benefits and adverse events after concurrent chemoradiotherapy. Key words: Lung neoplasm/three-dimensional radiotherapy; Prognosis; Adverse event