title: Radiochemotherapy in the elderly with lung cancer.
abstract: Lung cancer is the leading cause of cancer mortality with the median age of incidence being 69 years in males and 67 years in females. Radiochemotherapy (RT-CHT) is indicated in locally advanced non-small-cell lung cancer and limited-stage small-cell lung cancer; however, a significant under-representation of the elderly has been observed in patient recruitment in cancer treatment trials. In the last decades of the 20th Century, studies showed that elderly patients achieved the best quality-adjusted survival with radiotherapy alone, but recent trials have found that fit elderly patients benefit from concurrent RT-CHT, although with more short-term toxicity. Age alone should not exclude fit patients and deprive them of the standard treatment. Using tools, such as comprehensive geriatric assessment, a patient's tolerance to therapy can be assessed and monitoring can be performed. This review will focus on RT-CHT treatment in elderly patients with nonoperable stage III non-small-cell lung cancer and limited-stage small-cell lung cancer exclusively.
authors.affiliation: Radiation Oncology Department, Hospital Clinic Barcelona, Villaroel 170, 08036 Barcelona, Spain. fcasas@clinic.ub.es
authors.forename: Francesc
authors.initials: F
authors.lastname: Casas
authors.forename: Lucyna
authors.initials: L
authors.lastname: Kepka
authors.forename: Jai Prakash
authors.initials: JP
authors.lastname: Agarwal
authors.forename: D
authors.initials: D
authors.lastname: Dawotola
authors.forename: Pm
authors.initials: P
authors.lastname: Gaye
authors.forename: Sherif
authors.initials: S
authors.lastname: Abdel-Wahab
authors.forename: L
authors.initials: L
authors.lastname: Vashkevitch
authors.forename: T
authors.initials: T
authors.lastname: Saghatelyan
authors.forename: B
authors.initials: B
authors.lastname: Perin
authors.forename: Branislav
authors.initials: B
authors.lastname: Jeremic
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy; D008297:Male; D009367:Neoplasm Staging; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents