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Cited by 222Lung Cancer Diagnosis and TreatmentLung Cancer Research StudiesLung Cancer Treatments and Mutations

The outcome of combined-modality therapy for stage III non-small-cell lung cancer in the elderly

Schild, Steven E., Stella, Philip J., Geyer, Susan M., Bonner, James A., McGinnis, William L., Mailliard, James A., Brindle, Jeffery, Jatoi, Aminah +1 more·2003·Journal of Clinical Oncology
DOI 10.1200/jco.2003.12.019
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Abstract

Purpose: The North Central Cancer Treatment Group performed a phase III trial to determine whether chemotherapy plus either bid radiation therapy (RT) or daily (qd) RT resulted in a better outcome for patients with stage III non–small-cell lung cancer (NSCLC). No difference in survival was identified between the two arms. This secondary analysis was performed to examine the relationship between patient age and outcome. Patients and Methods: Two hundred forty-six patients were randomized to receive etoposide plus cisplatin and either RT qd or split-course RT bid. This retrospective study compared the outcomes of patients aged ≥70 years (“elderly patients”) with those of younger individuals. Of the 244 assessable patients, 63 (26%) were elderly, and 181 (74%) were younger individuals. Results: The 2-year and 5-year survival rates were 39% and 18%, respectively, in patients younger than 70 years, compared with 36% and 13%, respectively, in elderly patients (P = .4). Grade 4+ toxicity occurred in 62% of patients younger than 70 years compared with 81% of elderly patients (P = .007). Grade 4+ hematologic toxicity occurred in 56% of patients younger than 70 years, compared with 78% of elderly patients (P = .003). Grade 4+ pneumonitis occurred in 1% of those younger than 70 years, compared with 6% of elderly patients (P = .02). Conclusion: Toxicity, especially myelosuppression and pneumonitis, was more pronounced in the elderly patients receiving combined-modality therapy for locally advanced NSCLC. Despite increased toxicity, elderly patients have survival rates equivalent to younger individuals. Therefore, fit, elderly patients with locally advanced NSCLC should be encouraged to receive combined-modality therapy, preferably on clinical trials with cautious, judicious monitoring. Future studies should explore ways to decrease toxicity of therapy in elderly patients.

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Crossref · 10.1200/jco.2003.12.019

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Authors
Schild, S. E., Stella, P. J., Geyer, S. M., Bonner, J. A., McGinnis, W. L., Mailliard, J. A., Brindle, J., Jatoi, A., & Jett, J. R.
Affiliations
Mayo Clinic (US)
ORCID
Venue
Journal of Clinical Oncology
Publisher
American Society of Clinical Oncology (ASCO)
Published
2003-09-01
Volume
21
Issue
17
Pages
3201-3206
ISSN
  • 0732-183X (ISSN-L)
  • 1527-7755
DOI
10.1200/jco.2003.12.019
OpenAlex
W2082687472
Cited by
222
References
24
Citations by year
2025: 4 · 2024: 5 · 2023: 1 · 2022: 5 · 2021: 6 · 2020: 6 · 2019: 3 · 2018: 14 · 2017: 9 · 2016: 12 · 2015: 8 · 2014: 9 · 2013: 12 · 2012: 24
FWCI
7.56
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Clinical Oncology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (5u10ca063826-02)
  • National Cancer Institute (CA 35101, CA- 35113, CA- 35269, CA35103, CA35195, U10CA035113, U10CA035103, CA 52352, CA-63849, U10CA063848, (CA-25224, CA-37404, CA 63826, U10CA037404, U10CA025224, U10CA052352, U10CA035195, U10CA063849, CA 60276, CA-35416, U10CA035269, CA 15083, U10CA035101, U10CA060276, P30CA015083, CA-63848)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
Keywords
stage III NSCLC, elderly patients, multimodal therapy, etoposide plus cisplatin, survival, treatment toxicity, myelosuppression, pneumonitis, age and treatment outcome
MeSH terms
Adult, Age Factors, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Carcinoma, Non-Small-Cell Lung, Cisplatin, Combined Modality Therapy, Etoposide, Female, Humans, Lung Neoplasms, Male, Middle Aged, Radiotherapy Dosage, Retrospective Studies, Chi-Square Distribution, Survival Analysis, Treatment Outcome, Disease Progression

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