Chemotherapy and radiation given together could help elderly patients with lung cancer live longer

May 21, 2012

Despite more than two-thirds of lung cancer cases being diagnosed in people 65 years or older, there have been few trials of treatments in this age group, and it is not known if the standard treatment for patients with inoperable non-small-cell lung cancer (NSCLC)—combined chemoradiotherapy—is suitable for elderly patients. However, new research published Online First in The Lancet Oncology shows that giving a daily low-dose of the chemotherapy drug carboplatin at the same time as radiotherapy significantly prolongs survival in elderly patients compared with radiotherapy alone.

"[Until now] evidence supporting standard treatment with concurrent chemoradiotherapy was from clinical trials in which elderly, especially frail elderly patients, were under-represented"*, explains Shinji Atagi from Kinki-chuo Chest Medical Center, Osaka, Japan who led the research. "This trial is the first to show that combined radiotherapy can safely improve outcome of stage III NSCLC in elderly patients."

The Japan Clinical Oncology Group 0301 trial randomly assigned 200 patients aged 71 years or older with inoperable NSCLC to chemoradiotherapy (with carboplatin that is known to have a more favourable toxicity profile in elderly patients) or radiotherapy alone.

Results showed that patients given combined chemoradiotherapy were nearly a third less likely to die than those given alone at a median follow-up of 19.4 months (overall survival 22.4 vs 16.9 months).

Although chemoradiation was well tolerated more than half of patients experienced grade 3-4 toxic effects including leucopenia and neutropenia, compared with none in the radiotherapy-alone group. Infections were also more common with chemoradiotherapy, but most were manageable with treatment.

The authors conclude: "Combined treatment is feasible and tolerable in elderly patients with locally advanced NSCLC and should be considered for this population."

In an linked Comment, Juan Wisnivesky from Mount Sinai School of Medicine, New York and Gary Strauss from Tufts Medical Center, Boston caution: "The unexpectedly large survival advantage for concurrent chemoradiation raises concerns about the representativeness of the sample of elderly patients…and the results might not be valid for the broader population of older patients with stage III NSCLC…Additional validation of the present findings is needed before concurrent chemoradiation can be considered standard of care in ."

Explore further: Elderly Dutch lung patients' survival improved by new treatment options between 2003-2009

More information: Study online: www.thelancet.com/journals/lan … (12)70139-0/abstract

Related Stories

Elderly Dutch lung patients' survival improved by new treatment options between 2003-2009

July 6, 2011
New developments such as stereotactic ablative radiotherapy and improvements in surgical care in early-stage lung cancer have led to large survival gains for elderly Dutch patients, according to a population-based study presented ...

Concurrent chemo and radiation confers survival benefit in nasopharyngeal carcinoma patients

November 5, 2011
The combination of chemotherapy and radiation significantly improved the 5-year overall survival of patients with stage II nasopharyngeal carcinoma (NPC), according to a phase III study published Nov. 4 in the Journal of ...

Recommended for you

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.