BACKGROUND: The objective of this study was to assess the value of combined-modality therapy in elderly patients by comparing the differences in outcome between patients who received radiotherapy (RT) alone and patients who received RT plus chemotherapy for stage III nonsmall cell lung cancer (NSCLC). METHODS: The North Central Cancer Treatment Group performed 2 recent Phase III trials for stage III NSCLC. The first trial, NCCTG 90-24-51, included 3 arms: once-daily RT (QDRT) alone, twice-daily RT (BIDRT) alone, and concurrent chemotherapy plus BIDRT. The second trial, NCCTG 94-24-52, included 2 arms and compared concurrent chemotherapy with either QDRT or BIDRT. The chemotherapy arms of both trials included etoposide and cisplatin administered concurrently with RT. Only the patients aged >/=65 years (elderly) who participated in those trials were included in this analysis. RESULTS: Of the 166 elderly patients who were included in this analysis, 37 patients received RT alone, and 129 patients received concurrent chemotherapy plus RT. The median and 5-year survival rates were 10.5 months and 5.4% for the RT alone group compared with 13.7 months and 14.7% for the RT plus chemotherapy group (log-rank P = .05). Patients who received RT plus chemotherapy experienced significantly greater severe toxicity (grade >/=3) compared with patients who received RT alone (89.9% vs 32.4%; P < 0.01). CONCLUSIONS: Elderly patients who participated in these trials appeared to gain a survival advantage from RT and chemotherapy compared with RT alone. As is the case with younger patients, this benefit came at the cost of additional toxicity.
BACKGROUND: The objective of this study was to assess the value of combined-modality therapy in elderly patients by comparing the differences in outcome between patients who received radiotherapy (RT) alone and patients who received RT plus chemotherapy for stage III nonsmall cell lung cancer (NSCLC). METHODS: The North Central Cancer Treatment Group performed 2 recent Phase III trials for stage III NSCLC. The first trial, NCCTG 90-24-51, included 3 arms: once-daily RT (QDRT) alone, twice-daily RT (BIDRT) alone, and concurrent chemotherapy plus BIDRT. The second trial, NCCTG 94-24-52, included 2 arms and compared concurrent chemotherapy with either QDRT or BIDRT. The chemotherapy arms of both trials included etoposide and cisplatin administered concurrently with RT. Only the patients aged >/=65 years (elderly) who participated in those trials were included in this analysis. RESULTS: Of the 166 elderly patients who were included in this analysis, 37 patients received RT alone, and 129 patients received concurrent chemotherapy plus RT. The median and 5-year survival rates were 10.5 months and 5.4% for the RT alone group compared with 13.7 months and 14.7% for the RT plus chemotherapy group (log-rank P = .05). Patients who received RT plus chemotherapy experienced significantly greater severe toxicity (grade >/=3) compared with patients who received RT alone (89.9% vs 32.4%; P < 0.01). CONCLUSIONS: Elderly patients who participated in these trials appeared to gain a survival advantage from RT and chemotherapy compared with RT alone. As is the case with younger patients, this benefit came at the cost of additional toxicity.
Authors: A Jatoi; S E Schild; N Foster; G T Henning; K J Dornfeld; P J Flynn; T R Fitch; S R Dakhil; K M Rowland; P J Stella; G S Soori; A A Adjei Journal: Ann Oncol Date: 2010-06-21 Impact factor: 32.976
Authors: Waddah B Al-Refaie; Paul A Decker; Karla V Ballman; Peter W T Pisters; Mitchell C Posner; Kelly K Hunt; Bryan Meyers; Armin D Weinberg; Heidi Nelson; Lisa Newman; Angelina Tan; Jennifer G Le-Rademacher; Arti Hurria; Aminah Jatoi Journal: Ann Surg Oncol Date: 2019-10-11 Impact factor: 5.344
Authors: Thomas E Stinchcombe; Ying Zhang; Everett E Vokes; Joan H Schiller; Jeffrey D Bradley; Karen Kelly; Walter J Curran; Steven E Schild; Benjamin Movsas; Gerald Clamon; Ramaswamy Govindan; George R Blumenschein; Mark A Socinski; Neal E Ready; Wallace L Akerley; Harvey J Cohen; Herbert H Pang; Xiaofei Wang Journal: J Clin Oncol Date: 2017-05-11 Impact factor: 44.544
Authors: Eric D Miller; James L Fisher; Karl E Haglund; John C Grecula; Meng Xu-Welliver; Erin M Bertino; Kai He; Peter G Shields; David P Carbone; Terence M Williams; Gregory A Otterson; Jose G Bazan Journal: J Thorac Oncol Date: 2018-01-08 Impact factor: 15.609
Authors: Axel Grothey; Alex A Adjei; Steve R Alberts; Edith A Perez; Kurt A Jaeckle; Charles L Loprinzi; Daniel J Sargent; Jeff A Sloan; Jan C Buckner Journal: Semin Oncol Date: 2008-10 Impact factor: 4.929