Benefits and Adverse Events Among Elderly Patients Receiving Concurrent Chemoradiotherapy for Locally Advanced Non-small Cell Lung Cancer: Analysis of the Okayama Lung Cancer Study Group Trial 0007

Takigawa, Nagio; Kiura, Katsuyuki; Segawa, Yoshihiko; Hotta, Katsuyuki; Tamaoki, Akihiko; Tokuda, Yoshiyuki; Nagata, Takuya; Watanabe, Kazuhiko; Gemba, Kenichi; Moritaka, Tomonori; Horita, Naokatsu; Takeda, Hiromasa; Okimoto, Niro; Takemoto, Mitsuhiro; Matsuo, Keitaro; Shinkai, Tetsu; Tabata, Masahiro; Ueoka, Hiroshi; Kanazawa, Susumu; Tanimoto, Mitsune

doi:10.1097/jto.0b013e318213f86a

Cited by 17 publications

(9 citation statements)

References 13 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There remain controversial results regarding age factors (Table 3). Several studies have reported that CCRT could benefit appropriately selected elderly patients [14,16]. In a subgroup analysis of elderly patients (≥75 years), the median survival time was 31 months for those with adequate pulmonary function (DL CO > 80%), with a small tumor volume (GTV < 100 cm 3 ).…”

Section: Patient Fitness and Age Restrictions For Ccrtmentioning

confidence: 99%

Multidisciplinary team approach for the management of patients with locally advanced non-small cell lung cancer: searching the evidence to guide the decision

Ahn

2017

Radiat Oncol J

View full text Add to dashboard Cite

Locally advanced non-small cell lung cancer (LA-NSCLC) is composed of heterogeneous subgroups that require a multidisciplinary team approach in order to ensure optimal therapy for each patient. Since 2010, the National Comprehensive Cancer Network has recommended chemoradiation therapy (CRT) for bulky mediastinal disease and surgical combination for those patients with single-station N2 involvement who respond to neoadjuvant therapy. According to lung cancer tumor boards, thoracic surgeons make a decision on the resectability of the tumor, if it is determined to be unresectable, concurrent CRT (CCRT) is considered the next choice. However, the survival benefit of CCRT over sequential CRT or radiotherapy alone carries the risk of additional toxicity. Considering severe adverse events that may lead to death, fit patients who are able to tolerate CCRT must be identified by multidisciplinary tumor board. Decelerated approaches, such as sequential CRT or high-dose radiation alone may be a valuable alternative for patients who are not eligible for CCRT. As a new treatment strategy, investigators are interested in the application of the innovative radiation techniques, trimodality therapy combining surgery after high-dose definitive CCRT, and the combination of radiation with targeted or immunotherapy agents. The updated results and on-going studies are thoroughly reviewed in this article.

show abstract

Section: Patient Fitness and Age Restrictions For Ccrtmentioning

confidence: 99%

Multidisciplinary team approach for the management of patients with locally advanced non-small cell lung cancer: searching the evidence to guide the decision

Ahn

2017

Radiat Oncol J

View full text Add to dashboard Cite

show abstract

“…In our data, there was no difference between age groups in the incidence of severe esophageal toxicity ≥Grade 3, while the patients aged older than 75 experienced more frequent severe lung toxicity. However, CCRT could benefit appropriately selected elderly patients (17). In a subgroup analysis of elderly patients (>75 years) in our study, the median survival time was 31 months for those with adequate pulmonary function (DLCO > 80%), with a small tumor volume (GTV < 100 cm 3 ), and without subcarinal lymph node involvement.…”

Section: Discussionmentioning

confidence: 85%

Predictive factors for survival and correlation to toxicity in advanced Stage III non-small cell lung cancer patients with concurrent chemoradiation

Kim

Ahn

Kim³

et al. 2015

Jpn. J. Clin. Oncol.

View full text Add to dashboard Cite

Objective: Concurrent chemoradiotherapy is the standard treatment for locally advanced Stage III non-small cell lung cancer in patients with a good performance status and minimal weight loss. This study aimed to define subgroups with different survival outcomes and identify correlations with the radiation-related toxicities. Methods: We retrospectively reviewed 381 locally advanced Stage III non-small cell lung cancer patients with a good performance status or weight loss of <10% who received concurrent chemoradiotherapy between 2004 and 2011. Three-dimensional conformal radiotherapy was administered once daily, combined with weekly chemotherapy. The Kaplan-Meier method was used for survival comparison and Cox regression for multivariate analysis. Multivariate analysis was performed using all variables with P values <0.1 from the univariate analysis. Results: Median survival of all patients was 24 months. Age > 75 years, the diffusion lung capacity for carbon monoxide ≤80%, gross tumor volume ≥100 cm 3 and subcarinal nodal involvement were the statistically significant predictive factors for poor overall survival both in univariate and multivariate analyses. Patients were classified into four groups according to these four predictive factors. The median survival times were 36, 29, 18 and 14 months in Groups I, II, III and IV, respectively (P < 0.001).Rates of esophageal or lung toxicity ≥Grade 3 were 5.9, 14.1, 12.5 and 22.2%, respectively. The radiotherapy interruption rate differed significantly between the prognostic subgroups; 8.8, 15.4, 22.7 and 30.6%, respectively (P = 0.017). Conclusion: Severe toxicity and interruption of radiotherapy were more frequent in patients with multiple adverse predictive factors. To maintain the survival benefit in patients with concurrent chemoradiotherapy, strategies to reduce treatment-related toxicities need to be deeply considered.

show abstract

“…Both trials consisted almost entirely of patients with PS 0 to 1, and the treatment was given with curative intent (radiation 60 Gy). 25,29 In a subanalysis of a phase III trial, Jalal et al 30 …”

Section: Discussionmentioning

confidence: 99%

How Do Elderly Poor Prognosis Patients Tolerate Palliative Concurrent Chemoradiotherapy for Locally Advanced Non–Small-Cell Lung Cancer Stage III? A Subset Analysis From a Clinical Phase III Trial

Strøm

Bremnes

Sundstrøm

et al. 2015

Clinical Lung Cancer

View full text Add to dashboard Cite

Elderly patients aged ≥ 70 years with unresectable, stage III, locally advanced, NSLCL and a poor prognosis can tolerate CRT with the doses adjusted to age and palliative intent. These results indicate that CRT can provide both survival and QOL benefits in elderly patients, except for those with PS 2 or worse. The male predominance in the ≥ 70-year-age group and the reduced chemotherapy intensity for the patients aged > 75 years might explain the lack of significant survival improvement among those patients aged ≥ 70 years.

show abstract

Benefits and Adverse Events Among Elderly Patients Receiving Concurrent Chemoradiotherapy for Locally Advanced Non-small Cell Lung Cancer: Analysis of the Okayama Lung Cancer Study Group Trial 0007

Abstract: Chemotherapy with concurrent RT may be effective and tolerable in elderly patients with locally advanced non-small cell lung cancer.

Cited by 17 publications

References 13 publications

Multidisciplinary team approach for the management of patients with locally advanced non-small cell lung cancer: searching the evidence to guide the decision

Multidisciplinary team approach for the management of patients with locally advanced non-small cell lung cancer: searching the evidence to guide the decision

Predictive factors for survival and correlation to toxicity in advanced Stage III non-small cell lung cancer patients with concurrent chemoradiation

How Do Elderly Poor Prognosis Patients Tolerate Palliative Concurrent Chemoradiotherapy for Locally Advanced Non–Small-Cell Lung Cancer Stage III? A Subset Analysis From a Clinical Phase III Trial

Contact Info

Product

Resources

About