title: Outcomes of Elderly Patients Who Receive Combined Modality Therapy for Locally Advanced Non-Small-Cell Lung Cancer.
abstract: The objective of this study was to review our institution's experience among patients with locally advanced non-small-cell lung cancer (LA-NSCLC) treated with chemotherapy and radiation and to determine the prognostic significance of age.
  
  
  
  Patients were included if they underwent sequential or concurrent chemoradiotherapy from 2006 to 2014 for LA-NSCLC. Patients were stratified according to age ≤70 and >70 years. Kaplan-Meier and Cox regression methods were performed to evaluate overall survival (OS) and progression-free survival (PFS).
  
  
  
  One hundred twenty-three patients were identified. Ninety-eight patients were 70 years of age or younger and 25 patients were older than 70 years of age. The median radiotherapy dose was 6660 cGy (range, 3780-7600 cGy). A greater percentage of elderly patients were men, 72% (18 patients) versus 39% (38 patients) (P = .006) and received carboplatin/paclitaxel-based chemotherapy, 60% (15 patients) versus 21% (20 patients) (P < .001). Median follow-up for OS was 25.9 (95% confidence interval [CI], 21.3-33.9) months. There was no difference in the PFS of older patients versus younger patients (hazard ratio [HR], 1.15; P = .64), adjusted for significant covariates. The 1-year PFS rate for patients 70 years of age or younger was 51% (95% CI, 42%-63%) versus 45% (95% CI, 28%-71%) in patients older than 70 years. After adjusting for significant covariates, there was no difference in the OS of older patients compared with younger patients (HR, 1.18; P = .65). The 1-year OS rate for patients 70 years of age or younger was 77% (95% CI, 68%-86%) versus 56% (95% CI, 39%-81%) in patients younger than 70 years.
  
  
  
  Chemoradiotherapy is an effective treatment in elderly patients with LA-NSCLC, with outcomes similar to that in younger patients. Appropriately selected elderly patients should be considered for chemoradiation.
authors: Division of Radiation Oncology, Department of Oncology, Karmanos Cancer Center, Wayne State University School of Medicine, Detroit, MI. Electronic address: mazaki@med.wayne.edu.
authors: Mark
authors: M
authors: Zaki
authors: Division of Radiation Oncology, Department of Oncology, Karmanos Cancer Center, Wayne State University School of Medicine, Detroit, MI.
authors: Michael
authors: M
authors: Dominello
authors: Biostatistics, Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI.
authors: Gregory
authors: G
authors: Dyson
authors: Department of Oncology, Karmanos Cancer Center, Wayne State University School of Medicine, Detroit, MI.
authors: Shirish
authors: S
authors: Gadgeel
authors: Department of Oncology, Karmanos Cancer Center, Wayne State University School of Medicine, Detroit, MI.
authors: Antoinette
authors: A
authors: Wozniak
authors: Division of Radiation Oncology, Department of Oncology, Karmanos Cancer Center, Wayne State University School of Medicine, Detroit, MI.
authors: Steven
authors: S
authors: Miller
authors: Division of Radiation Oncology, Department of Oncology, Karmanos Cancer Center, Wayne State University School of Medicine, Detroit, MI.
authors: Peter
authors: P
authors: Paximadis
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018287:Carcinoma, Large Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Chemotherapy; Geriatric; Oncology; Radiation; Retrospective study