Concurrent chemoradiation for elderly patients with locally advanced non-small-cell lung cancer: still a controversial issue

Author： Westeel Virginie Quoix Elisabeth Baudrin Laurence Milleron Bernard

Publisher： Future Medicine

ISSN： 1745-509X

Source： Aging Health, Vol.8, Iss.2, 2012-04, pp. : 119-122

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Abstract

Evaluation of: Jalal SI, Riggs HD, Melnyk A et al. Updated survival and outcomes for older adults with inoperable stage III non-small-cell lung cancer treated with cisplatin, etoposide, and concurrent chest radiation with or without consolidation docetaxel: analysis of a Phase III trial from the Hoosier Oncology Group (HOG) and US Oncology. Ann. Oncol. doi:10.1093/annonc/mdr565 (2011) (Epub ahead of print). The paper by Jalal et al. reports updated survival of a Phase III trial of concurrent chemoradiation with or without consolidation docetaxel for locally advanced non-small-cell lung cancer, and efficacy and tolerability data in patients ≥70 years. Of the 243 enrolled patients, 166 were randomized and 64 were aged ≥70 years (26%). There was no benefit of consolidation docetaxel. Median and 3-year survival was 17.1 months and 21.8% in patients ≥70 years, and 22.8 months and 34% in patients <70 years, respectively (p = 0.15). There were significantly more grade 3–4 toxicities (87 vs 73%; p = 0.02) and more hospitalizations in elderly patients (45 vs 32%; p = 0.03), but no increase in toxic deaths. Concurrent chemoradiation can be an option in elderly patients. However, significantly higher toxicity should be taken into account and elderly patients highly selected.