Impact of palliative radiotherapy to the prognosis of patients with stage IV non-small cell lung cancer

Objective To investigate the impact of palliative radiotherapy to the prognosis of patients with stage Ⅳ non-small cell lung cancer (NSCLC).Methods Two hundred and forty-four cases of stage Ⅳ NSCLC were collected from our hospital.The study group (n =129) received the treatment of primary tumor and metastases palliative radiotherapy after chemotherapy.The control group (n =115) received only chemotherapy.Followed-up and compared 1-year and 2-year survival rate of the patients,and explored the factors affecting palliative radiotherapy.Results The 129 patients in the study group were followed up for 2 years,and 16 patients survived and 110 patients died.Three patients were lost to follow-up.The median survival time was 8 months.1-year and 2-year survival rates was 29.46％ (38/129) and 12.40％ (16/129) respectively.In the control group,7 patients survived,and 106 patients died.Two patients were lost to follow up.The median survival time was 6 months.1-year and 2-year survival rates was 11.30％ (13/115) and 6.09％ (7/115)respectively.Survival rates between the two groups were significantly different (x2 =8.451,P =0.014)Univariate regression analysis found that factors affecting the prognosis of stage Ⅳ NSCLC were KPS score (x2 =5.057,P =0.031),occurrence of brain metastases (x2 =4.781,P =0.029),number of organs of metastasis (x2 =6.341,P =0.010),and the primary stove radiotherapy dose (x2 =5.893,P =0.015) ; Cox regression model analysis showed that the number of organs of metastasis (HR =1.719,95％ CI 为 1.172-3.126,P =0.008),the primary focal radiotherapy dose (HR =1.560,95％ CI 为 1.082-2.761,P =0.022) were independent prognostic factors.Conclusion Palliative radiotherapy plays a role of prolonging survival time in the treatment of Ⅳ NSCLC.In palliative radiotherapy,we should pay attention to the control of the primary tumor and metastases radiotherapy dose,therefore prolonging the survival time of patients. Key words: Non-small cell lung cancer;  Radiotherapy ;  Chemotherapy;  Prognosis