Elderly patients with inoperable non-small-cell lung cancer (NSCLC) have been shown to benefit from a combination of chemotherapy and radiotherapy.
In a Japanese trial, patients aged over 70 who received daily carboplatin with radiotherapy lived significantly longer than those given radiotherapy alone.
The trial, published in The Lancet, is the first to support the use of concurrent chemoradiotherapy in elderly and severely ill patients.
The study divided 200 participants with inoperable NSCLC randomly into two groups, receiving radiotherapy or chemoradiotherapy.
The overall survival for the chemoradiotherapy arm was 22.4 months, significantly longer than for the radiotherapy arm (16.9 months).
Most of the patients given chemoradiotherapy suffered some toxic effects, but the researchers judged the treatment to be “feasible and tolerable” and concluded that it “should be considered for this population”.
According to Shinji Atagi of Kinki-chuo Chest Medical Center, Osaka, Japan, elderly people were “under-represented” in previous trials of combined therapy. “This trial is the first to show that combined therapy can safely improve the outcome of stage III NSCLC in elderly patients,” he said.
However, Juan Wisnivesky of Mount Sinai School of Medicine, New York and Gary Strauss of Tufts Medical Center, Boston, warned: “Additional validation of the present findings is needed before concurrent chemoradiation can be considered standard of care in elderly patients.”