Chemoradiotherapy in Elderly Patients With Non-Small-Cell Lung Cancer: Long-Term Follow-Up of a Randomized Trial (JCOG0301).

Abstract

INTRODUCTION:

In the phase III JCOG0301 trial, chemoradiotherapy (CRT) with daily low-dose carboplatin showed significant benefits in elderly patients with locally advanced non-small-cell lung cancer (NSCLC) compared with radiotherapy (RT) alone. However, the long-term patterns and cumulative incidences of toxicity associated with CRT and RT in elderly patients are not well elucidated. We report long-term survival data and late toxicities after a minimum follow-up of 6.4 years.

PATIENTS AND METHODS:

Eligible patients were older than 70 years and had unresectable stage III NSCLC. They were randomly assigned to RT or CRT. Prognosis and adverse events data were collected beyond those in the initial report. Late toxicities were defined as occurring more than 90 days after RT initiation.

RESULTS:

From September 2003 to May 2010, 200 patients (RT arm, n = 100; CRT arm, n = 100) were enrolled. Consistent with the initial report, the CRT arm had better overall survival than the RT arm (hazard ratio, 0.743; 95% confidence interval, 0.552-0.998; 1-sided P = .0239). The proportion of Grade 3/4 late toxicities were 7.4% (heart 2.1%, lung 5.3%) in the RT arm (n = 94) and 7.5% (esophagus 1.1%, lung 6.5%) in the CRT arm (n = 93). No additional cases of late toxicity (Grade 3/4) and treatment-related death have been seen since the initial report that was published.

CONCLUSION:

Long-term follow-up confirmed the survival benefits of CRT for elderly patients with locally advanced NSCLC. There was no observed increase in late toxicity with CRT compared with RT alone.

• Authors: Shinji Atagi, Junki Mizusawa, Satoshi Ishikura, Toshiaki Takahashi, Hiroaki Okamoto, Hiroshi Tanaka, Koichi Goto, Kazuhiko Nakagawa, Masao Harada, Yuichiro Takeda, Naoyuki Nogami, Yuka Fujita, Takashi Kasai, Kazuma Kishi, Toshiyuki Sawa, Koji Takeda, Keisuke Tomii, Miyako Satouchi, Takashi Seto, Yuichiro Ohe
• Journal: Clinical lung cancer (Clin Lung Cancer) Vol. 19 Issue 5 Pg. e619-e627 (09 2018) ISSN: 1938-0690 [Electronic] United States
• PMID: 29887243 (Publication Type: Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Topics

• Adenocarcinoma (pathology, therapy)
• Aged
• Aged, 80 and over
• Carcinoma, Large Cell (pathology, therapy)
• Carcinoma, Non-Small-Cell Lung (pathology, therapy)
• Carcinoma, Squamous Cell (pathology, therapy)
• Chemoradiotherapy (mortality)
• Female
• Follow-Up Studies
• Humans
• Lung Neoplasms (pathology, therapy)
• Male
• Prognosis
• Survival Rate