Clinical Observation Of Gamma-Knife Stereotactic Radiotherapy In 50 Elderly Patients With Advanced Lung Cancer

Objective To analyze the effects and prognostic factors of gamma-knife stereotactic radiotherapy in the treatment of elderly patients with advanced lung cancer. Methods From January 2005 to November 2011, 50 patients aged ≥70 years with advanced lung cancer were only treated with gamma-knife stereotactic fraction radiotherapy and all pa-tients previously hadn't accepted radiotherapy, chemotherapy and target therapy. A total dose of (42.30±4.25) Gy were prescribed to the 40%-80% isodose line and in 5-14 fraction of 3.5-8 Gy each for primary tumor. A total dose of (35.32± 5.17) Gy were prescribed to the 40%-80% isodose line and in 6-13 fraction of 3.5-5 Gy each for metastatic tumor, one time per day,five times per week. Blood count, blood chemistry, tumor markers and imaging were tested every 1-3 months after treatment. Follow-up time was 2-54 months and ended in December 2012. Results The response rate was 86%, with 17 cases of complete remission and 26 cases of partial remission. Overall sursvival time was 2-54 months with a median survival time of 12 months and an average survival time of 19.76 months. 1-4 years survival rate was 50%,28%,13% and 8% respectively. According to RTOG standard radiotherapy reaction, 5( 10%) patients presented with gradeⅠand 3( 6%) patients with grade Ⅱ hematology adverse effects. 5 ( 10%) patients presented with grade Ⅰ and 4 ( 8%) patients with grade Ⅱ gastrointestinal adverse effects. 12(24%) patients presented with grade Ⅰ and 3(6%) patients with grade Ⅲradiqation pneumotitis. Kaplan-meier method univariate analysis showed that primary tumor prescription dose was a prognos-tic factor ( P=0.045) . Conclusions Gamma-knife treatment as an optional way is effective for elderly patients with ad-vanced lung cancer with mild toxicity, which can prolong patients' survival time and improve their quality of life.