Survival Benefit Associated With Chemoradiotherapy in Older Patients

Chemoradiotherapy (CRT) may provide additional overall survival (OS) benefit in older patients with limited-stage small-cell lung cancer, in comparison to chemotherapy (CT) alone, according an article published in the Journal of Clinical Oncology.¹

Investigators identified 8,637 patients from the National Cancer Data Base who were ≥70 years, diagnosed with limited-stage small-cell lung cancer, and treated with CT (3,775; 43.7%) or CRT (4,862; 56.3%) from 2003 to 2011. The likelihood of receiving CRT decreased with increasing age, stage 3 disease, female sex, and comorbidities (all P<.01).

In univariable and multivariable analyses, CRT administration increased survival (median OS, 15.6 vs 9.3 months; 3-year OS, 22.0% vs 6.3%; log-rank P<.001; Cox P<.001). OS benefit with CRT was also observed in a matched cohort of 6,856 patients (hazard ratio, 0.52; 95% CI, 0.5-0.55; P<.001).

In a subset analysis with patients alive for 4 months after diagnosis, a survival advantage was displayed with concurrent CRT in comparison to sequential CRT (median OS, 17.0 vs 15.4 months; log-rank P=.01).

Authors concluded that the survival benefit associated with CRT warrants its preference in older patients who are anticipated to tolerate toxicities.

Reference

1. Corso CD, Decker RH. Role of chemoradiotherapy in elderly patients with limited-stage small-cell lung cancer [published online ahead of print October 19, 2015]. J Clin Oncol. doi: 10.1200/JCO.2015.62.4270.