TY - JOUR
T1 - Stage III Non-Small Cell Lung Cancer in the elderly
T2 - Patient characteristics predictive for tolerance and survival of chemoradiation in daily clinical practice
AU - Driessen, Elisabeth J.M.
AU - Bootsma, Gerbern P.
AU - Hendriks, Lizza E.L.
AU - van den Berkmortel, Franchette W.P.J.
AU - Bogaarts, Brigitte A.H.A.
AU - van Loon, Judith G.M.
AU - Dingemans, Anne Marie C.
AU - Janssen-Heijnen, Maryska L.G.
N1 - Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2016/10
Y1 - 2016/10
N2 - Background:In unselected elderly with stage III Non-Small Cell Lung Cancer (NSCLC), evidence is scarce regarding motives and effects of treatment modalities. Methods:Hospital-based multicenter retrospective study including unresectable stage III NSCLC patients aged ⩾70 and diagnosed between 2009 and 2013 (N = 216). Treatment motives and tolerance (no unplanned hospitalizations and completion of treatment), and survival were derived from medical records and the Netherlands Cancer Registry. Results: Patients received concurrent chemoradiation (cCHRT, 33%), sequential chemoradiation (sCHRT, 24%), radical radiotherapy (RT, 16%) or no curative treatment (27%). Comorbidity, performance status (58%) and patient refusal (15%) were the most common motives for omitting cCHRT. Treatment tolerance for cCHRT and sCHRT was worse in case of severe comorbidity (OR 6.2 (95%CI 1.6–24) and OR 6.4 (95%CI 1.8–22), respectively). One-year survival was 57%, 50%, 49% and 26% for cCHRT, sCHRT, RT and no curative treatment, respectively. Compared to cCHRT, survival was worse for no curative treatment (P = 0.000), but not significantly worse for sCHRT and RT (P = 0.38). Conclusion:Although relatively fit elderly were assigned to cCHRT, treatment tolerance was worse, especially for those with severe comorbidity. Survival seemed not significantly better as compared to sCHRT or RT. Prospective studies in this vital and understudied area are needed.
AB - Background:In unselected elderly with stage III Non-Small Cell Lung Cancer (NSCLC), evidence is scarce regarding motives and effects of treatment modalities. Methods:Hospital-based multicenter retrospective study including unresectable stage III NSCLC patients aged ⩾70 and diagnosed between 2009 and 2013 (N = 216). Treatment motives and tolerance (no unplanned hospitalizations and completion of treatment), and survival were derived from medical records and the Netherlands Cancer Registry. Results: Patients received concurrent chemoradiation (cCHRT, 33%), sequential chemoradiation (sCHRT, 24%), radical radiotherapy (RT, 16%) or no curative treatment (27%). Comorbidity, performance status (58%) and patient refusal (15%) were the most common motives for omitting cCHRT. Treatment tolerance for cCHRT and sCHRT was worse in case of severe comorbidity (OR 6.2 (95%CI 1.6–24) and OR 6.4 (95%CI 1.8–22), respectively). One-year survival was 57%, 50%, 49% and 26% for cCHRT, sCHRT, RT and no curative treatment, respectively. Compared to cCHRT, survival was worse for no curative treatment (P = 0.000), but not significantly worse for sCHRT and RT (P = 0.38). Conclusion:Although relatively fit elderly were assigned to cCHRT, treatment tolerance was worse, especially for those with severe comorbidity. Survival seemed not significantly better as compared to sCHRT or RT. Prospective studies in this vital and understudied area are needed.
UR - http://www.scopus.com/inward/record.url?scp=84992579464&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2016.07.025
DO - 10.1016/j.radonc.2016.07.025
M3 - Article
C2 - 27522577
AN - SCOPUS:84992579464
SN - 0167-8140
VL - 121
SP - 26
EP - 31
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -
