Chemoradiation Versus Radiation Alone in Elderly Patients With Lung Cancer
Chemoradiation therapy (CRT) appears to offer a survival advantage compared with radiation therapy alone in elderly patients with stage III non–small cell lung cancer (NSCLC), according to new findings published in the Journal of Thoracic Oncology. Although the optimal sequencing of chemotherapy and radiation remains unclear in this patient population, sequential CRT was superior to concurrent CRT in this study.
“Treatment of the elderly with stage III non–small cell lung cancer should involve a multidisciplinary discussion. All patients not eligible for surgery should first be considered for chemoradiation, with either concurrent or sequential radiation,” concluded lead author Eric D. Miller, MD, PhD, of the Department of Radiation Oncology at The Ohio State University.
Researchers used the National Cancer Database to find patients at least 70 years old with stage III NSCLC not treated surgically. Of that population, 5,023 patients were treated with definitive radiation therapy, and 18,206 were treated with definitive CRT.
CRT was associated with improved overall survival compared with radiation before and after propensity score matching (with a 0.66 and 0.91 hazard ratios, respectively). After propensity score matching, treatment with CRT corresponded to a 33% reduction in the risk of death, with a hazard ratio of 0.67.
Additionally, in the CRT sample, 2,366 were treated with sequential CRT, and 15,840 were treated with concurrent CRT. The investigators found that treatment with sequential CRT corresponded to a 9% reduction in the risk of death.