The value of combined-modality therapy in elderly patients with stage III nonsmall cell lung cancer

Steven E. Schild, Sumithra J Mandrekar, Aminah Jatoi, William L. McGinnis, Phillip J. Stella, Richard L. Deming, James R. Jett, Yolanda Isabel Garces, Katie L. Allen, Alex Adjei

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)363-368
Number of pages6
JournalCancer
Volume110
Issue number2
DOIs
StatePublished - Jul 15 2007

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Combined Modality Therapy
Non-Small Cell Lung Carcinoma
Radiotherapy
Drug Therapy
Etoposide
Cisplatin

Keywords

  • Cisplatin
  • Concurrent therapy
  • Elderly
  • Etoposide
  • Nonsmall cell lung cancer
  • North Central Cancer Treatment Group
  • Radiation therapy
  • Severe toxicity
  • Stage III

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

The value of combined-modality therapy in elderly patients with stage III nonsmall cell lung cancer. / Schild, Steven E.; Mandrekar, Sumithra J; Jatoi, Aminah; McGinnis, William L.; Stella, Phillip J.; Deming, Richard L.; Jett, James R.; Garces, Yolanda Isabel; Allen, Katie L.; Adjei, Alex.

In: Cancer, Vol. 110, No. 2, 15.07.2007, p. 363-368.

Research output: Contribution to journalArticle

Schild, Steven E. ; Mandrekar, Sumithra J ; Jatoi, Aminah ; McGinnis, William L. ; Stella, Phillip J. ; Deming, Richard L. ; Jett, James R. ; Garces, Yolanda Isabel ; Allen, Katie L. ; Adjei, Alex. / The value of combined-modality therapy in elderly patients with stage III nonsmall cell lung cancer. In: Cancer. 2007 ; Vol. 110, No. 2. pp. 363-368.
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abstract = "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.",
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AU - Schild, Steven E.

AU - Mandrekar, Sumithra J

AU - Jatoi, Aminah

AU - McGinnis, William L.

AU - Stella, Phillip J.

AU - Deming, Richard L.

AU - Jett, James R.

AU - Garces, Yolanda Isabel

AU - Allen, Katie L.

AU - Adjei, Alex

PY - 2007/7/15

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N2 - 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.

AB - 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.

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KW - Elderly

KW - Etoposide

KW - Nonsmall cell lung cancer

KW - North Central Cancer Treatment Group

KW - Radiation therapy

KW - Severe toxicity

KW - Stage III

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