Weekly administration of paclitaxel and carboplatin with concurrent thoracic radiation in previously untreated elderly patients with locally advanced non-small-cell lung cancer: A case series of 20 patients.
Elderly patients with stage III non-small-cell lung cancer (NSCLC) are frequently underrepresented in clinical trials that evaluate chemoradiotherapy, due to their poor functional status, coexisting illnesses and limited life expectancy. The Japan Clinical Oncology Group 0301 trial (JCOG0301) was the first study to demonstrate that thoracic radiation therapy (TRT) with daily low-dose carboplatin may improve the outcome of elderly patients with stage III NSCLC. However, the efficacy and safety profiles of chemoradiotherapy, including platinum doublets, have not been clearly determined in this patient population. We retrospectively assessed the efficacy and toxicity of weekly paclitaxel in combination with carboplatin and concurrent TRT in patients aged ≥75 years with previously untreated locally advanced NSCLC. Between February, 2004 and July, 2013, we collected the data of 20 patients treated with weekly paclitaxel and carboplatin for 6 weeks and concurrent TRT. The objective response rate was 90%, the disease control rate was 95%, the median progression-free survival was 8.63 months [95% confidence interval (CI): 5.7-16.7] and the median overall survival (OS) was 16.1 months (95% CI: 10.7-41.6). There were no grade 4 hematological or non-hematological toxicities and no reported treatment-related deaths. Therefore, platinum doublet therapy in combination with TRT did not provide a clinically significant survival benefit in our population of elderly patients with locally advanced NSCLC. However, the present study demonstrated the good feasibility and safety of this regimen. Further prospective clinical trials are required to evaluate the efficacy and safety of platinum doublet with TRT in elderly patients.
Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Jumpei
J
Takeshita
Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Katsuhiro
K
Masago
Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Shiro
S
Fujita
Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Akito
A
Hata
Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Reiko
R
Kaji
Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Takahisa
T
Kawamura
Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Koji
K
Tamai
Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Takeshi
T
Matsumoto
Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Kazuma
K
Nagata
Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Kyoko
K
Otsuka
Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Atsushi
A
Nakagawa
Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Kojiro
K
Otsuka
Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Keisuke
K
Tomii
Division of Radiation Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Takashi
T
Shintani
Division of Radiation Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Kenji
K
Takayama
Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
Masaki
M
Kokubo
Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan ;
Nobuyuki
N
Katakami
chemoradiotherapy; elderly patient; locally advanced non-small cell lung cancer; paclitaxel; platinum doublet