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Concurrent chemoradiotherapy should be used with caution in elderly patients
Wang Peng, Liu Weishuai, Xu Liming, Wang Shuai, Pang Qingsong, Yuan Zhiyong, Wang Jun,Zhao Lujun, Wang Ping
Department of Radiation Oncology, Tianjin Medical University Cancer Hospital,Tianjin Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center for Cancer,Tianjin 300060, China
Abstract Objective We aimed to investigate whether the standard approach of concurrent chemotherapy and radiation is an appropriate choice for elderly patients with limited-stage small-cell lung cancer (LS-SCLC). Methods A total of 168 LS-SCLC patients who had received thoracic radiotherapy from January 2006 to December 2011 at our institution were included in this retrospective study. Patients aged 65 years or older were defined as elder,and we compare concurrent chemoradiotherapy (CCRT) to sequential chemoradiotherapy (SCRT) in the elderly group (53 patients) and in its younger (153 patients) counterpart. Results The follow-up rate was 95.2%(each of the two groups lost in 4 patients).The median OS and PFS for the entire cohort was 24.6 months and 15.4 months. Among the elderly patients, the median OS were 15.9 and 24.6 months (P=0.013) in the CCRT and SCRT subgroups, respectively, and the toxicity were similar except for that more grade 3/4 hematological toxicity events were observed in the CCRT subgroup (13.3% versus 2.6%, P=0.170). Among the young patients, the median OS was 39.6 months in the CCRT subgroup and 24.5 months in the SCRT group (P=0.018), and no significant differences occurred in toxicity between the two subgroups (P=0.250-0.757). Conclusions Concurrent chemoradiotherapy should be used with caution in elderly patients, and sequential chemotherapy may be an alternative choice.
Wang Peng,Liu Weishuai,Xu Liming et al. Concurrent chemoradiotherapy should be used with caution in elderly patients[J]. Chinese Journal of Radiation Oncology, 2015, 24(3): 237-240.
Wang Peng,Liu Weishuai,Xu Liming et al. Concurrent chemoradiotherapy should be used with caution in elderly patients[J]. Chinese Journal of Radiation Oncology, 2015, 24(3): 237-240.
[1] Jemal A, Bray F, Center MM, et al. Global cancer statistics[J]. CA Cancer J Clin,2011,61(2):69-90.DOI:10.3322/caac.20107. [2] Owonikoko TK, Ragin CC, Belani CP, et al. Lung cancer in elderly patients:an analysis of the surveillance, epidemiology, and end results database[J]. J Clin Oncol,2007,25(35):5570-5577.DOI:10.1200/JCO.2007.12.5435. [3] Turrisi AR, Kim K, Blum R, et al. Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide[J]. N Engl J Med,1999,340(4):265-271. [4] Sun JM, Ahn YC, Choi EK, et al. Phase Ⅲ trial of concurrent thoracic radiotherapy with either first-or third-cycle chemotherapy for limited-disease small-cell lung cancer[J]. Ann Oncol,2013,24(8):2088-2092.DOI:10.1093/annonc/mdt140. [5] Simon GR, Turrisi A. Management of small cell lung cancer:ACCP evidence-based clinical practice guidelines (2nd edition)[J]. Chest,2007,132(3 Suppl):S324-S339.DOI:10.1378/chest.07-138 5. [6] Murray N, Coy P, Pater JL, et al. Importance of timing for thoracic irradiation in the combined modality treatment of limited-stage small-cell lung cancer. The National Cancer Institute of Canada Clinical Trials Group[J]. J Clin Oncol,1993,11(2):336-344. [7] Klautke G, Sauer R, Fietkau R. Combined treatment modality in small cell lung cancer:the impact of radiotherapy on survival[J]. Strahlenther Onkol,2008,184(2):61-66.DOI:10.1007/s00066-008-1839-x. [8] Pignon JP, Arriagada R, Ihde DC, et al. A meta-analysis of thoracic radiotherapy for small-cell lung cancer[J]. N Engl J Med,1992,327(23):1618-1624. [9] Quon H, Shepherd FA, Payne DG, et al. The influence of age on the delivery, tolerance, and efficacy of thoracic irradiation in the combined modality treatment of limited stage small cell lung cancer[J]. Int J Radiat Oncol Biol Phys,1999,43(1):39-45. [10] Yuen AR, Zou G, Turrisi AT, et al. Similar outcome of elderly patients in intergroup trial 0096:Cisplatin, etoposide, and thoracic radiotherapy administered once or twice daily in limited stage small cell lung carcinoma[J]. Cancer,2000,89(9):1953-1960. [11] Schild SE, Stella PJ, Brooks BJ, et al. Results of combined-modality therapy for limited-stage small cell lung carcinoma in the elderly[J]. Cancer,2005,103(11):2349-2354. [12] Ludbrook JJ, Truong PT, Macneil MV, et al. Do age and comorbidity impact treatment allocation and outcomes in limited stage small-cell lung cancer? a community-based population analysis[J]. Int J Radiat Oncol Biol Phys,2003,55(5):1321-1330.DOI:10.1016/S0360-3016(02)04576-5. [13] Kuo YH, Lin ZZ, Yang YY, et al. Survival of patients with small cell lung carcinoma in Taiwan[J]. Oncology,2012,82(1):19-24.DOI:10.1159/000335084. [14] Shukuya T, Takahashi T, Harada H, et al. Chemoradiotherapy for limited-disease small-cell lung cancer in elderly patients aged 75 years or older[J]. Jpn J Clin Oncol,2013,43(2):176-183.DOI:10.1093/jjco/hys197.
2015, Vol. 24 
