A high percentage of patients with limited-stage small cell lung cancer (SCLC) are elderly, but there is a lack of data concerning the efficacy and safety of concurrent chemo-radiotherapy in this patient population to help guide treatment decision making.
To clarify this problem, researchers presented results of a retrospective analysis of data from the Concurrent Once-daily Versus Twice-daily Radiotherapy (CONVERT) trial at the International Association for the Study of Lung Cancer (IASLC) 17th Annual World Conference on Lung Cancer in Austria.1
Patients in the CONVERT trial were randomized to receive 45 Grays (Gy) of radiotherapy in 30 twice-daily fractions over 3 weeks or 66Gy in 33 once-daily fractions over 6.5 weeks, beginning on day 22 of cycle 1 chemotherapy, followed by prophylactic cranial radiation if indicated.
Of the 490 patients included in the trial, 67 (13.7%) were 70 years or older with a median age of 73 years. A higher percentage of patients who were younger than 70 received 30 or 33 fractions of radiotherapy (85% vs 73%). Grade 3 or 4 neutropenia occurred more frequently in the older group (84% vs 70%), but there was no significant difference in neutropenic sepsis or non-hematological acute or late toxicities.
At median follow-up of 46 months, 2-year survival was 53% in the older group and 57% in the younger group. Median survival was 29 months in the older group and 30 months in the younger group. Hazard ratios for overall survival and progression free survival were 1.15 and 1.04, respectively. In the older group, median survival was not significantly different among patients who received once vs twice daily radiotherapy.
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Based on their analysis, the authors concluded that concurrent chemo-radiotherapy is a viable treatment option for elderly patients with good performance status.
- Christodoulou M, Blackhall F, Ashcroft L, et al. Compliance and outcome of elderly patients treated in the Concurrent Once-Daily versus Twice-Daily RadioTherapy (CONVERT) trial. Paper presented at: International Association for the Study of Lung Cancer 17th World Conference on Lung Cancer; December 2016; Vienna, Austria.