Survival Analysis and Treatment Strategies for Locally Advanced Lung Squamous Cell Carcinoma in Elderly Patients

Abstract

Background: The aim of the study was to analyze the survival and treatment strategies of elderly patients with locally advanced lung squamous cell carcinoma.

Methods: A retrospective analysis was conducted on the clinical and follow-up data of 278 patients with locally advanced lung squamous cell carcinoma admitted to the Fourth Hospital of Hebei Medical University from January 2012 to December 2019.

Results: The 1-, 3-, 5-, and 10-year survival rates of the entire group were 86.0%, 50.6%, 40.8%, and 24.2%, respectively. There were a total of 142 cases aged 65 or elder, with 1-, 3-, 5-, and 10-year survival rates of 83.9%, 44.3%, 32.3%, and 15.6%, respectively. Among them, the progression-free survival (PFS) of the elderly group receiving radiotherapy dose ≥ 60 Gy was significantly prolonged compared to the < 60 Gy group (although P > 0.05). Comprehensive radiotherapy and chemotherapy showed a significant trend of prolonging overall survival (OS) compared to simple radiotherapy (Breslow = 0.029, log rank = 0.126). χ² tests were performed for radiotherapy doses < 60 Gy and ≥ 60 Gy, PFS < 12 months and ≥ 12 months, OS < 36 months and ≥ 36 months, respectively. The proportion of PFS ≥ 12 months was significantly higher in the 60 Gy group (P = 0.043), and the proportion of OS ≥ 36 months was higher in the PFS ≥ 12 months group (P = 0.001).

Conclusion: The prognosis of locally advanced unresectable lung squamous cell carcinoma is poor, especially in elderly patients. If the patient’s general condition is good, it is recommended to receive radiation therapy with a dose of ≥ 60 Gy and try comprehensive treatment with tolerable toxic side effects.