1202P - Outcomes of aggressive concurrent chemotherapy in septuagenarians with stage IIIB non-small cell lung carcinoma

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Anticancer agents
Geriatric Oncology
Surgical oncology
Non-small-cell lung cancer
Therapy
Biological therapy
Radiation oncology
Presenter Erkan Topkan
Authors E. Topkan1, C. Parlak2, S. Topuk1, O. Ozyilkan3
  • 1Department Of Radiation Oncology, Baskent University Adana Medical Faculty, 01120 - Adana/TR
  • 2Baskent University Adana Medical Faculty, 01120 - Adana/TR
  • 3Medical Oncology, Baskent University Faculty of MedicineAdana Uygulama Ve Arastirma Mer., TR-01120 - Adana/TR

Abstract

Background

Aim of the study was to retrospectively assess the feasibility of radical chemoradiotherapy in terms of tolerability and survival outcomes in medically fit 71 to 79 years old stage IIIB NSCLC patients.

Materials and methods

From the hospital records, 78 medically fit, septuagenerians with stage IIIB lung carcinoma were evaluated. Patients should have performance of ECOG 0-1, body mass index of ≥20kg/m2, and weight loss of <%5 in within 1 year. Patients were staged with PET-CT besides conventional workup, and suspicious mediastinal nodes were verified by mediastinoscopy of transbronchial needle biopsy. Thoracic radiotherapy (TRT) to a total dose of 66 Gy in 2 Gy fractions was delivered concurrently with 2 cycles of chemotherapy (CT); CV (n = 46): cisplatin (80 mg/m2) and vinorelbine (30 mg/m2, D1, 8), or CD (n = 32): cisplatin (80 mg/m2) and docetaxel (80 mg/m2).

Results

Patients characteristics are given in Table 1. All patients received planned 66 Gy TRT but 55 of them (70.5%) could receive 2 cycles of chemotherapy. In general, treatment was well-tolerated with no grade 4/5 acute toxicity. Late term toxicity was reported in 3 (3.8%); esophagitis in 3 and peripheral neuropathy in 1 patient. At a median follow up of 19.3 months (4.4-39.8), 19 patients (24.4%) were alive, 8 of whom (10.3%) were with no disease progression. Median overall, local-regional progression-free and progression-free survival were 17.5 (95%CI: 15.2-19.8), 10.1 (95% CI: 7.8-12.4) and 7.3 months (95% CI: 5.9-8.9). On univariate analyses, histology (p = 0.017), Nodal status (p = 0.011), number of concomitant CT (p < 0.001), weight change during CRT (p < 0.001) were found to be associated with overall survival; while only number of CT and weight change (p < 0.001 for each) was found to be as prognostic factor.

Age Median 74.4 (71 – 79)
Sex Male Female 51 (65.4) 27 (34.6)
Performance status ECOG 0 ECOG 1 38 (48.7) 40 (51.3)
Histology SCC Adeno 43 (55.1) 35 (44.9)
Stage T2N3 T3N3 T4N2 T4N3 15 (19.2) 22 (28.2) 28 (35.9) 13 (16.7)

Conclusion

Results present here suggests that CRT in highly selected medically fit septuagenarians with LA-NSCLC yields survival outcomes improved up to that achieved in younger patients, with a relatively acceptable toxicity profile. Table 1

Disclosure

All authors have declared no conflicts of interest.