Published in:
01-11-2014 | Original article
Older patients with inoperable non-small cell lung cancer
Long-term survival after concurrent chemoradiotherapy
Published in: Strahlentherapie und Onkologie | Issue 12/2014
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Purpose
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.
Patients and 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.
Conclusion
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).