title: Older patients with inoperable non-small cell lung cancer: long-term survival after concurrent chemoradiotherapy.
abstract: OBJECTIVE
  Considering the various comorbidities associated with aging, the feasibility and usefulness of concurrent chemoradiotherapy (CRT) in older patients with inoperable non-small cell lung cancer (NSCLC) is a controversial issue. Here, we compared the feasibility of CRT and the effects of various comorbidities on the prognosis of a minimally selected population of inoperable NSCLC patients aged 60-77 years.
  
  
  METHODS
  The study comprised 161 patients with inoperable NSCLC who received CRT with a target radiation dose greater than  60 Gy and platinum-based chemotherapy from 1998 to 2007. The total population included 69 patients aged 60-69 years and 53 aged 70-77 years. These two age cohorts were included in the study with a follow-up of a median 14.5 months.
  
  
  RESULTS
  The two groups showed no differences in long-term survival, as reflected by the 5-year survival rates of 13.0 ± 4.1 % (60- to 69-year-olds) and 14.4 ± 4.9 % (70- to 77-year-olds). During the treatment phase, the groups were comparable in terms of toxicity and the feasibility of chemotherapy. Compared to patients in their 60s, the septuagenarians had more pulmonary comorbidities (p = 0.02), diabetes mellitus (p = 0.04), cardiac comorbidities (p = 0.08), and previous cancer disease (p = 0.08) that exerted a negative effect on survival. In patients without comorbidities, there were no differences between the age groups.
  
  
  CONCLUSIONS
  Age is not a contraindication for concurrent CRT per se, because elderly patients do not have a worse long-term prognosis than younger seniors. However, "elderly patients" (≥ 70-77 years) have more concomitant diseases associated with shorter survival than "moderately aged patients" (≥ 60-69 years).
authors.affiliation: Department of Radiation Oncology, Friedrich-Alexander-University Erlangen-Nürnberg, Universitätsstraße 27, 91054, Erlangen, Germany, sabine.semrau@uk-erlangen.de.
authors.forename: Sabine
authors.initials: S
authors.lastname: Semrau
authors.forename: Heike
authors.initials: H
authors.lastname: Zettl
authors.forename: Guido
authors.initials: G
authors.lastname: Hildebrandt
authors.forename: Gunther
authors.initials: G
authors.lastname: Klautke
authors.forename: Rainer
authors.initials: R
authors.lastname: Fietkau
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000628:therapy*; D059248:Chemoradiotherapy / Q000401:mortality*; D018572:Disease-Free Survival; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome
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