Elderly patients with inoperable non-small-cell lung cancer (NSCLC) who take a daily dose of carboplatin (a chemotherapy drug), in addition to radiotherapy, live significantly longer than those who receive radiotherapy alone, say Japanese researchers. The study is published Online First in The Lancet Oncology.

Shinji Atagi from Kinki-chuo Chest Medical Center, Osaka, Japan, said:

“[Until now] evidence supporting standard treatment with concurrent chemoradiotherapy was from clinical trials in which elderly, especially frail elderly patients, were under-represented. This trial is the first to show that combined radiotherapy can safely improve outcome of stage III NSCLC in elderly patients.”

The researchers enrolled 200 patients aged 71+ with inoperable NSCLC to participate in the study. Participants were then randomly assigned to receive either radiotherapy alone or chemoradiotherapy.

The researchers found that overall survival for participants assigned to chemoradiotherapy was significantly greater (22.4 months) than for patients assigned to radiotherapy alone (16.9 months).

Even though chemoradiation was well tolerated, over half of participants experienced grade 3-4 toxic effects including neutropenia and leucopeni, whereas no toxic effects were experienced by those assigned to radiotherapy alone. In addition, infections were more prevalent among patients assigned to chemoradiation.

The researchers conclude: “Combined treatment is feasible and tolerable in elderly patients with locally advanced NSCLC and should be considered for this population.”

In an joint comment, Juan Wisnivesky from Mount Sinai School of Medicine, New York and Gary Strauss from Tufts Medical Center, Boston, said:

“The unexpectedly large survival advantage for concurrent chemoradiation raises concerns about the representativeness of the sample of elderly patients – and the results might not be valid for the broader population of older patients with stage III NSCLC. Additional validation of the present findings is needed before concurrent chemoradiation can be considered standard of care in elderly patients.”

Written By Grace Rattue