A study first presented at the Annual Meeting of the American Radium Society (May 2–5) in Kauai, HI, and now published in the Journal of Clinical Oncology, may help to better define the role of chemoradiotherapy (CRT) in the treatment of older adults with stage I–III small-cell lung cancer.
Researchers from the Yale University School of Medicine (New Haven, CT) identified elderly patients (aged 70 years or older) with limited stage small-cell lung cancer who received chemotherapy (CT) or CRT from 2003 to 2011, using the National Cancer Data Base. Overall survival was the primary outcome measure for each treatment method.
In total, the study looked at 8637 patients, 3775 of whom received CT and 4862 of whom received CRT. The usage of CRT decreased with increasing age and was less common in patients with clinical stage III disease, female gender, and medical comorbidities. Patients who were treated with CRT had higher rates of overall survival than those treated with CT. A propensity-score–matched cohort of 6856 patients confirmed the findings. Subset analysis also showed that patients who were alive 4 months after diagnosis derived a survival benefit from concurrent CRT versus sequential CRT.
The researchers concluded: “In elderly patients with limited-stage small-cell lung cancer, modern CRT appears to confer an additional [overall survival] advantage beyond that achieved with CT alone in a large population-based cohort. Our findings suggest that CRT should be the preferred strategy in elderly patients who are expected to tolerate the toxicities of the combined approach.”
