title: 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.
abstract: BACKGROUND
  Concurrent chemoradiation with etoposide and cisplatin (EP/XRT) is standard treatment for inoperable stage III locally advanced non-small-cell lung cancer (LA-NSCLC). Consolidation docetaxel (D; Taxotere) after EP/XRT resulted in increased toxicity but no improvement in survival compared with observation (O). We report updated survival for the entire study population and include an analysis of efficacy and tolerability of EP/XRT with or without D in patients aged ≥ 70 years.
  
  
  METHODS
  Hoosier Oncology Group LUN 01-24 enrolled 243 patients with LA-NSCLC and randomized 166 after EP/XRT to three cycles of D versus O. the trial was terminated after an analysis of the first 203 patients demonstrated futility of D.
  
  
  RESULTS
  Median survival time (MST) for the overall study population was 21.5 months, and 3-, 4-, and 5-year survival rates were 30.7%, 18.0%, and 13.9%, respectively. No differences in MST or 3-year survival were noted between D and O arms. Older patients had similar MST (17.1 versus 22.8 months for younger patients, P = 0.15) but higher rates of grade 3/4 toxicity and hospitalization during induction.
  
  
  CONCLUSIONS
  Consolidation docetaxel after EP/XRT does not improve survival in LA-NSCLC. Fit older adults with LA-NSCLC benefit from concurrent chemoradiation similarly as younger patients but experience higher rates of hospitalization and toxicity.
authors.affiliation: Division of Hematology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA. sjalal@iupui.edu
authors.forename: S I
authors.initials: SI
authors.lastname: Jalal
authors.forename: H D
authors.initials: HD
authors.lastname: Riggs
authors.forename: A
authors.initials: A
authors.lastname: Melnyk
authors.forename: D
authors.initials: D
authors.lastname: Richards
authors.forename: A
authors.initials: A
authors.lastname: Agarwala
authors.forename: M
authors.initials: M
authors.lastname: Neubauer
authors.forename: R
authors.initials: R
authors.lastname: Ansari
authors.forename: R
authors.initials: R
authors.lastname: Govindan
authors.forename: D
authors.initials: D
authors.lastname: Bruetman
authors.forename: W
authors.initials: W
authors.lastname: Fisher
authors.forename: T
authors.initials: T
authors.lastname: Breen
authors.forename: C S
authors.initials: CS
authors.lastname: Johnson
authors.forename: M
authors.initials: M
authors.lastname: Yu
authors.forename: L
authors.initials: L
authors.lastname: Einhorn
authors.forename: N
authors.initials: N
authors.lastname: Hanna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D060830:Consolidation Chemotherapy; D018572:Disease-Free Survival; D000077143:Docetaxel; D057239:Early Termination of Clinical Trials; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D005047:Etoposide; D002945:Cisplatin