Gefitinib Combination with Radiotherapy in Patients with Local Advanced Non-Small Cell Lung Cancer

Background: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors is a crucial agent in EGFR-mutated advanced lung disease. Previous studies have suggested a positive correlation between EGFR overexpression and cellular radioresistance in the treatment of non-small cell lung cancer (NSCLC). Concurrent or sequential Gefitinib with thoracic irradiation showed tolerability and possible efficacy in patients who exhibited EGFR mutation. The aim of this study was to improve treatment outcomes of local advanced NSCLC patients.Method: A prospective study included stage III NSCLC cases divided in to 30 patients in Arm A and 20 patients in Arm B. The patients received thoracic irradiation concurrently or sequentially with Gefitinib. We used Kaplan-Meier plot and compared results using log-rank test. Percent of categorical variables was compared using Pearson’s chi-square test or Fisher’s exact test when appropriate. A P-value of less than 0.05 was considered to be statistically significant using SPSS 16.0.Results: Pneumonitis was more observed toxicity in Arm A versus Arm B with statistical significance P = 0.039. The median progression-free survival was 10 months with a 95 % confidence interval range of 8.2-11.7 months, 8.5-11.4 months in Arm A and Arm B, respectively. The median overall survival was 18 months versus 16 months with the range at 95 % confidence interval of 12.6-23.3 months versus 13.2-18.7 months in Arm A and Arm B, respectively.Conclusion: Gefitinib is affordable and effective with thoracic irradiation in stage III NSCLC patients with accepted toxicity profile.