title: Outcomes of aggressive concurrent radiochemotherapy in highly selected septuagenarians with stage IIIB non-small cell lung carcinoma: retrospective analysis of 89 patients.
abstract: We retrospectively evaluated the toxicity and efficacy of concurrent radiochemotherapy (C-RCT) in medically fit septuagenarians with stage IIIB non-small cell lung carcinoma (NSCLC). Eighty-nine medically fit, stage IIIB NSCLC septuagenarians were included. Thoracic radiotherapy to a total dose of 66 Gy in 2 Gy fractions was delivered concurrently with 1-2 cycles of cisplatin-based doublet chemotherapy. Treatment was relatively well-tolerated with no grade 4/5 acute toxicity. Acute grade 3 hematologic and non-hematologic toxicity rates were 55.1 and 39.3%, respectively. Late toxicity was reported in 3 (3.4%) patients: esophagitis (N = 2) and peripheral neuropathy (N = 1). At median 21.7 months (4.4-42.1), 26 patients (29.2%) were alive. Median overall, local-regional progression-free and progression-free survivals were 17.7, 10.5 and 7.8 months, respectively. On univariate analyses, histology (p < 0.03), nodal status (p = 0.038), number of concomitant chemotherapy (p < 0.001), and weight change during C-RCT (p < 0.001) demonstrated significant association with overall survival; while only number of chemotherapy and weight change (p < 0.001 for each) could retain their significance on multivariate analyses. Current results suggested that C-RCT in highly selected medically fit septuagenarians with LA-NSCLC may improve survival outcomes up to that achieved in younger patients, with a relatively acceptable toxicity profile.
authors.affiliation: Baskent University, Adana Medical Faculty, Department of Radiation Oncology, Adana, Turkey. docdretopkan@gmail.com
authors.forename: Erkan
authors.initials: E
authors.lastname: Topkan
authors.forename: Cem
authors.initials: C
authors.lastname: Parlak
authors.forename: Savas
authors.initials: S
authors.lastname: Topuk
authors.forename: Ozan Cem
authors.initials: OC
authors.lastname: Guler
authors.forename: Ugur
authors.initials: U
authors.lastname: Selek
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods; D002945:Cisplatin / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy*; D008297:Male; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Concurrent chemoradiotherapy; Elderly; Non-small cell lung cancer; Stage IIIB; Survival outcome; Treatment tolerability