High-dose radiation therapy for elderly patients with inoperable or unresectable non-small cell lung cancer

Hayakawa, Kazushige; Mitsuhashi, Norio; Katano, Susumu; Saito, Yoshihiro; Nakayama, Yuko; Sakurai, Hideyuki; Akimoto, Tetsuo; Hasegawa, Masatoshi; Yamakawa, Michitaka; Niibe, Hideo

doi:10.1016/s0169-5002(00)00219-1

Cited by 59 publications

(28 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These studies showed that the majority of patients ultimately die of disseminated lung carcinoma rather than comorbid conditions, and that treatmentrelated complications are uncommon with doses of 60 to 65 Gy, even among elderly patients (37). Although some studies suggested better survival rates with increasing doses of radiation (10,14,20), others did not (7,11).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Radiation Therapy for Elderly Patients with Unresected Stage I and II Non–Small Cell Lung Cancer

Wisnivesky

Halm

Bonomi

et al. 2010

Am J Respir Crit Care Med

View full text Add to dashboard Cite

Rationale: Radiotherapy (RT) is considered the standard treatment for patients with stage I or II non-small lung cancer who are not surgical candidates because of comorbities or preferences against surgery. Objectives: To compare the outcomes of patients treated with RT alone with those who were untreated to assess the effect of RT on survival. Methods: Using the Surveillance, Epidemiology and End Results (SEER) registry linked to Medicare files, we identified 6,065 unresected patients with histologically confirmed stage I and stage II non-small cell lung cancer, diagnosed between 1992 and 2002. We used propensity score methods and instrumental variable analysis to control for the possible effects of known as well as unmeasured confounders. Measurements and Main Results: Overall, 59% of patients received RT. The overall and lung cancer-specific survival of unresected patients treated with RT was significantly better compared with the untreated cases (P , 0.0001 for both comparisons). RT was associated with a 6-month improvement in median overall survival. Propensity score analyses showed that RT was associated with improved overall (hazard ratio, 0.74; 95% confidence interval, 0.70-0.78) and lung cancer-specific survival (hazard ratio, 0.73; 95% confidence interval, 0.69-0.78). Instrumental variable analysis also indicated improved outcomes among patients treated with RT. Conclusions: RT improves survival of elderly patients with unresected stage I or II lung cancer. These results should be confirmed in prospective trials.

show abstract

Section: Discussionmentioning

confidence: 99%

Effectiveness of Radiation Therapy for Elderly Patients with Unresected Stage I and II Non–Small Cell Lung Cancer

Wisnivesky

Halm

Bonomi

et al. 2010

Am J Respir Crit Care Med

View full text Add to dashboard Cite

show abstract

“…Reports are conflicting regarding the influence of age on the outcome of patients and the role of aggressive therapy in NSCLC locally advanced patients with unfavourable characteristics is controversial. Hayakawa, evaluating the results of elderly patients treated with high-dose radiation therapy for inoperable NSCLC, recommended definitive radiotherapy without chemotherapy, but a phase II study of the Southwest Oncology Group suggest, that patients with poor-risk features can tolerate and derive significant benefit from aggressive therapy [25,26]. Patients eligible for the Southwest Oncology Group phase II study had been excluded from cisplatin-based protocols because of poor pulmonary or renal function, congestive heart failure, hearing loss, peripheral neuropathy, or weight loss.…”

Section: Discussionmentioning

confidence: 99%

A phase II study of induction chemotherapy followed by concurrent chemoradiotherapy in elderly patients with locally advanced non-small-cell lung cancer

Giorgio¹,

Pappalardo²,

Russo

et al. 2007

Anti-Cancer Drugs

View full text Add to dashboard Cite

The optimal management of unresectable locally advanced non-small-cell lung cancer in older patients has not been defined to date. The present phase II study was planned to evaluate the activity and safety of platinum-based induction chemotherapy followed by concurrent chemoradiotherapy in elderly patients with locally advanced non-small-cell lung cancer. Patients received two cycles of paclitaxel (175 mg/m 2 ) and carboplatin (area under the curve: 5) day 1, every 3 weeks. Chemoradiotherapy (thoracic radiation therapy) was initiated on day 42 and consisted of 1.8 Gy daily, five times per week over 5 weeks (45.0 Gy target dose) followed by 10 2.0 Gy daily fractions. Concomitant chemotherapy was weekly paclitaxel 50 mg/mq followed by weekly carboplatin at an area under the curve of 2. The eligibility for patients: age 70 or older and histologically documented untreated non-small-cell lung cancer, locally advanced, unresectable, stage III A N2 bulky or III B. Thirty consecutive patients were enrolled onto the study. The median age was 73 (range 70-76). According to the intention-to-treat analysis, 1 month after the end of combined chemoradiotherapy, we observed complete and partial responses in one and 19 of the 30 patients, respectively, for an overall response rate of 66% (95% confidence interval, 45-76%). Median progression-free survival was 8.7 months (95% confidence interval, 3.4-37.8) and median survival was 15 months (95% confidence interval, 4.2-52.1). During the treatment, 12 patients (40.0%) experienced grade 3-4 neutropenia, two patients neutropenic fever, and three patients grade 3 anaemia and grade 3 thrombocytopenia, respectively. Grade 3 oesophagitis, during concomitant radiotherapy, was observed in six patients (20.0%). No treatment-related mortality was reported. The investigated sequential approach including induction chemotherapy followed by concurrent chemoradiotherapy appears safe and seems a reasonable chance for the treatment of locally advanced non-small-cell lung cancer in the elderly population.

show abstract

“…Radiation is capable of producing MST of 15-33 months and 5-year survivals of 0-42% for patients in stage I/II. Elderly patients can receive radical radiation treatment as safely as younger persons, and the survival results are the same [2,13]. We also use the radical radiotherapy for those who are considered to be inoperable because of insufficient physical function, or those who refuse surgical therapy.…”

Section: Discussionmentioning

confidence: 99%

Clinical patterns and treatment outcome of elderly patients in clinical stage IB/II non‐small cell lung cancer

Okamoto¹,

Maruyama²,

Fukushima³

et al. 2004

Journal of Surgical Oncology

View full text Add to dashboard Cite

show abstract

High-dose radiation therapy for elderly patients with inoperable or unresectable non-small cell lung cancer

Cited by 59 publications

References 25 publications

Effectiveness of Radiation Therapy for Elderly Patients with Unresected Stage I and II Non–Small Cell Lung Cancer

Effectiveness of Radiation Therapy for Elderly Patients with Unresected Stage I and II Non–Small Cell Lung Cancer

A phase II study of induction chemotherapy followed by concurrent chemoradiotherapy in elderly patients with locally advanced non-small-cell lung cancer

Clinical patterns and treatment outcome of elderly patients in clinical stage IB/II non‐small cell lung cancer

Contact Info

Product

Resources

About