Chemoradiotherapy Improves Survival for Elderly With NSCLC

Addition of carboplatin to radiotherapy prolongs overall survival in locally advanced disease

TUESDAY, May 22 (HealthDay News) -- For elderly patients with locally advanced non-small-cell lung cancer (NSCLC), treatment with radiotherapy plus carboplatin improves overall survival versus radiotherapy alone, according to a study published May 22 in The Lancet Oncology.

Shinji Atagi, M.D., from the Kinki-Chuo Chest Medical Center in Osaka, Japan, and colleagues conducted a randomized trial to assess survival in elderly patients (older than 70 years) with unresectable stage III NSCLC. Participants were randomly allocated to receive chemoradiotherapy (60 Gy with concurrent low-dose carboplatin; 100 patients) or radiotherapy alone (100 patients). Ten months after completion of patient accrual, a second planned interim analysis was conducted.

The researchers found that, based on the prespecified stopping rule, at the planned interim analysis, the Japan Clinical Oncology Group recommended early publication of the trial due to the improvement in overall survival in the chemoradiotherapy group. The median overall survival for the chemoradiotherapy group was 22.4 months, compared with 16.9 months for the radiotherapy-alone group (hazard ratio, 0.68). More patients in the chemoradiotherapy group experienced grade 3 to 4 hematologic toxic effects, and grade 3 infection was more common with chemoradiotherapy. There were similar incidences of grade 3 to 4 pneumonitis and late lung toxicity between the groups. Three treatment-related deaths occurred in the chemoradiotherapy group and four in the radiotherapy-alone group.

"The addition of daily low-dose carboplatin to thoracic radiotherapy in our selected population of elderly patients with locally advanced NSCLC provides a clinically significant benefit, and this combined modality should be considered in this setting," the authors write.

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