Abstract
Introduction
In the phase III JCOG0301 trial, chemoradiotherapy (CRT) with daily low-dose carboplatin
showed significant benefits in elderly patients with locally advanced non–small-cell
lung cancer (NSCLC) compared with radiotherapy (RT) alone. However, the long-term
patterns and cumulative incidences of toxicity associated with CRT and RT in elderly
patients are not well elucidated. We report long-term survival data and late toxicities
after a minimum follow-up of 6.4 years.
Patients and Methods
Eligible patients were older than 70 years and had unresectable stage III NSCLC. They
were randomly assigned to RT or CRT. Prognosis and adverse events data were collected
beyond those in the initial report. Late toxicities were defined as occurring more
than 90 days after RT initiation.
Results
From September 2003 to May 2010, 200 patients (RT arm, n = 100; CRT arm, n = 100)
were enrolled. Consistent with the initial report, the CRT arm had better overall
survival than the RT arm (hazard ratio, 0.743; 95% confidence interval, 0.552-0.998;
1-sided P = .0239). The proportion of Grade 3/4 late toxicities were 7.4% (heart 2.1%, lung
5.3%) in the RT arm (n = 94) and 7.5% (esophagus 1.1%, lung 6.5%) in the CRT arm (n =
93). No additional cases of late toxicity (Grade 3/4) and treatment-related death
have been seen since the initial report that was published.
Conclusion
Long-term follow-up confirmed the survival benefits of CRT for elderly patients with
locally advanced NSCLC. There was no observed increase in late toxicity with CRT compared
with RT alone.
Keywords
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Article info
Publication history
Published online: May 04, 2018
Accepted:
April 24,
2018
Received in revised form:
April 10,
2018
Received:
January 29,
2018
Footnotes
Clinical trial registration at umin.ac.jp/ctr: UMIN-CTR C000000060, and ClinicalTrials.gov: NCT00132665.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
