Elisabeth J M Driessen1, Gerbern P Bootsma2, Lizza E L Hendriks3, Franchette W P J van den Berkmortel4, Brigitte A H A Bogaarts5, Judith G M van Loon6, Anne-Marie C Dingemans3, Maryska L G Janssen-Heijnen7. 1. Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands. Electronic address: research@viecuri.nl. 2. Department of Pulmonology, Zuyderland Medical Centre, Heerlen, The Netherlands. 3. Department of Pulmonary Diseases, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands. 4. Department of Medical Oncology, Zuyderland Medical Centre, Heerlen, The Netherlands. 5. Department of Pulmonology, VieCuri Medical Centre, Venlo, The Netherlands. 6. MAASTRO Clinic, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands. 7. 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.
Abstract
BACKGROUND: In unselected elderly with stage III Non-Small Cell Lung Cancer (NSCLC), evidence is scarce regarding motives and effects of treatment modalities. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
BACKGROUND: In unselected elderly with stage III Non-Small Cell Lung Cancer (NSCLC), evidence is scarce regarding motives and effects of treatment modalities. METHODS: Hospital-based multicenter retrospective study including unresectable stage III NSCLCpatients 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. RESULTS: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). CONCLUSION: 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.
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