In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 15_suppl ( 2012-05-20), p. e17548-e17548
Abstract:
e17548 Background: CRT is the standard therapy in locally advanced NSCLC. Nevertheless, the best approach in the elderly population is still poorly defined. Methods: We retrospectively reviewed the charts of elderly (≥ 65 years) patients (pts) with diagnosed stage III (6th AJCC), unresectable, NSCLC, treated at the Brazilian National Cancer Institute (INCA) between 2003 and 2005. Pts with malignant pleural effusion were excluded. The primary outcome was overall survival (OS), measured from diagnosis until death. Prognostic factors were analyzed using log-rank and stepwise Cox model. Palliative therapy (PT) included best supportive care, radiation therapy (RT; ≤ 40 Gy), and palliative chemotherapy. Among pts treated with radical RT, OS was measured from date of treatment beginning until death (OST). Results: One hundred fifteen pts were included. Median age was 71 (range 65-83), 76% were male, 51% had squamous histology, and 82% stage IIIB. Seventy percent had more than 5% weigh loss at diagnosis, 44% had PS 0-1, while 29% and 26% had PS 2 and 3, respectively. Ninety percent were current/former-smokers, and Charlson comorbidity index (CCI) was 0 in 66% and 1-2 in 34%. Thirty-six percent received PT, 32% exclusive RT ( 〉 40 Gy), and 32% CRT (concomitant or sequential). Post-radiation surgery was not performed in this cohort. The median OS was 9.9 months (ms; 95% CI, 7.2-12.6). Survival was significantly longer among pts with PS 0-1 (p 〈 0.0001) and no weigh loss (p=0.026), while histology (p=0.15), tumor stage (p=0.51), CCI (p=0.37), and age (p=0.54) were not prognostic factors. Pts treated with exclusive RT and CRT had better OS (median 14.3 ms [95% CI, 11.7-16.9] and 17.0 ms [95% CI, 14.1-19.9] , respectively) than PT (median 4.1 ms [95% CI, 3.5-4.8]; p 〈 0.0001). In the multivariate analysis, RT (HR 0.25 [95% CI, 0.15-0.42]; p 〈 0.0001) and CRT (HR 0.16 [95% CI, 0.09-0.27]; p 〈 0.0001) were independently associated with better survival in comparison to PT. Among pts receiving radical RT, the addition of chemotherapy was associated with longer OST (median 14.1 vs 10.7 ms; p=0.025). Conclusions: CRT was independently associated with longer survival in elderly pts with locally advanced NSCLC.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.15_suppl.e17548
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
Permalink