title: Stage III Non-Small Cell Lung Cancer in the elderly: Patient characteristics predictive for tolerance and survival of chemoradiation in daily clinical practice.
abstract: In unselected elderly with stage III Non-Small Cell Lung Cancer (NSCLC), evidence is scarce regarding motives and effects of treatment modalities.
  
  
  
  Hospital-based multicenter retrospective study including unresectable stage III NSCLC patients aged ⩾70 and diagnosed between 2009 and 2013 (N=216). Treatment motives and tolerance (no unplanned hospitalizations and completion of treatment), and survival were derived from medical records and the Netherlands Cancer Registry.
  
  
  
  Patients received concurrent chemoradiation (cCHRT, 33%), sequential chemoradiation (sCHRT, 24%), radical radiotherapy (RT, 16%) or no curative treatment (27%). Comorbidity, performance status (58%) and patient refusal (15%) were the most common motives for omitting cCHRT. Treatment tolerance for cCHRT and sCHRT was worse in case of severe comorbidity (OR 6.2 (95%CI 1.6-24) and OR 6.4 (95%CI 1.8-22), respectively). One-year survival was 57%, 50%, 49% and 26% for cCHRT, sCHRT, RT and no curative treatment, respectively. Compared to cCHRT, survival was worse for no curative treatment (P=0.000), but not significantly worse for sCHRT and RT (P=0.38).
  
  
  
  Although relatively fit elderly were assigned to cCHRT, treatment tolerance was worse, especially for those with severe comorbidity. Survival seemed not significantly better as compared to sCHRT or RT. Prospective studies in this vital and understudied area are needed.
authors: Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands. Electronic address: research@viecuri.nl.
authors: Elisabeth J M
authors: EJ
authors: Driessen
authors: Department of Pulmonology, Zuyderland Medical Centre, Heerlen, The Netherlands.
authors: Gerbern P
authors: GP
authors: Bootsma
authors: Department of Pulmonary Diseases, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands.
authors: Lizza E L
authors: LE
authors: Hendriks
authors: Department of Medical Oncology, Zuyderland Medical Centre, Heerlen, The Netherlands.
authors: Franchette W P J
authors: FW
authors: van den Berkmortel
authors: Department of Pulmonology, VieCuri Medical Centre, Venlo, The Netherlands.
authors: Brigitte A H A
authors: BA
authors: Bogaarts
authors: MAASTRO Clinic, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
authors: Judith G M
authors: JG
authors: van Loon
authors: Department of Pulmonary Diseases, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands.
authors: Anne-Marie C
authors: AC
authors: Dingemans
authors: Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands; Department of Epidemiology, Maastricht University Medical Centre, GROW School for Oncology and Developmental Biology, The Netherlands.
authors: Maryska L G
authors: ML
authors: Janssen-Heijnen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D009426:Netherlands; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: Chemoradiation; Elderly; Motives; Non-Small Cell Lung Cancer; Survival; Tolerance