Concurrent chemoradiotherapy should be used with caution in elderly patients

Abstract

Objective We aimed to investigate whether the standard approach of concurrent chemotherapy and radiation is an appropriate choice for elderly patients with limited-stage small-cell lung cancer ( LS-SCLC). Methods A total of 168 LS-SCLC patients who had received thoracic radiotherapy from January 2006 to December 2011 at our institution were included in this retrospective study. Patients aged 65 years or older were defined as elder, and we compare concurrent chemoradiotherapy ( CCRT) to sequential chemoradiotherapy ( SCRT) in the elderly group (53 patients) and in its younger (153 patients) counterpart. Results The follow-up rate was 95.2% (each of the two groups lost in 4 patients). The median OS and PFS for the entire cohort was 24. 6 months and 15. 4 months. Among the elderly patients, the median OS were 15. 9 and 24. 6 months (P=0.013) in the CCRT and SCRT subgroups, respectively, and the toxicity were similar except for that more grade 3/4 hematological toxicity events were observed in the CCRT subgroup (13. 3% versus 2.6%, P = 0. 170). Among the young patients, the median OS was 39. 6 months in the CCRT subgroup and 24.5 months in the SCRT group (P=0.018), and no significant differences occurred in toxicity between the two subgroups (P = 0.250-0.757 ). Conclusions Concurrent chemoradiotherapy should be used with caution in elderly patients, and sequential chemotherapy may be an alternative choice. Key words: small cell lung carcinoma; elderly; concurrent chemotherapy and radiotherapy; sequential chemotherapy and radiotherapy