Skip to main content

Pooled Analysis of Individual Patient Data on Concurrent Chemoradiotherapy for Stage III Non-Small-Cell Lung Cancer in Elderly Patients Compared With Younger Patients Who Participated in US National Cancer Institute Cooperative Group Studies.

Publication ,  Journal Article
Stinchcombe, TE; Zhang, Y; Vokes, EE; Schiller, JH; Bradley, JD; Kelly, K; Curran, WJ; Schild, SE; Movsas, B; Clamon, G; Govindan, R; Pang, HH ...
Published in: J Clin Oncol
September 1, 2017

Purpose Concurrent chemoradiotherapy is standard treatment for patients with stage III non-small-cell lung cancer. Elderly patients may experience increased rates of adverse events (AEs) or less benefit from concurrent chemoradiotherapy. Patients and Methods Individual patient data were collected from 16 phase II or III trials conducted by US National Cancer Institute-supported cooperative groups of concurrent chemoradiotherapy alone or with consolidation or induction chemotherapy for stage III non-small-cell lung cancer from 1990 to 2012. Overall survival (OS), progression-free survival, and AEs were compared between patients age ≥ 70 (elderly) and those younger than 70 years (younger). Unadjusted and adjusted hazard ratios (HRs) for survival time and CIs were estimated by single-predictor and multivariable frailty Cox models. Unadjusted and adjusted odds ratio (ORs) for AEs and CIs were obtained from single-predictor and multivariable generalized linear mixed-effect models. Results A total of 2,768 patients were classified as younger and 832 as elderly. In unadjusted and multivariable models, elderly patients had worse OS (HR, 1.20; 95% CI, 1.09 to 1.31 and HR, 1.17; 95% CI, 1.07 to 1.29, respectively). In unadjusted and multivariable models, elderly and younger patients had similar progression-free survival (HR, 1.01; 95% CI, 0.93 to 1.10 and HR, 1.00; 95% CI, 0.91 to 1.09, respectively). Elderly patients had a higher rate of grade ≥ 3 AEs in unadjusted and multivariable models (OR, 1.35; 95% CI, 1.07 to 1.70 and OR, 1.38; 95% CI, 1.10 to 1.74, respectively). Grade 5 AEs were significantly higher in elderly compared with younger patients (9% v 4%; P < .01). Fewer elderly compared with younger patients completed treatment (47% v 57%; P < .01), and more discontinued treatment because of AEs (20% v 13%; P < .01), died during treatment (7.8% v 2.9%; P < .01), and refused further treatment (5.8% v 3.9%; P = .02). Conclusion Elderly patients in concurrent chemoradiotherapy trials experienced worse OS, more toxicity, and had a higher rate of death during treatment than younger patients.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

September 1, 2017

Volume

35

Issue

25

Start / End Page

2885 / 2892

Location

United States

Related Subject Headings

  • Randomized Controlled Trials as Topic
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Clinical Trials, Phase III as Topic
  • Clinical Trials, Phase II as Topic
  • Chemoradiotherapy
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Stinchcombe, T. E., Zhang, Y., Vokes, E. E., Schiller, J. H., Bradley, J. D., Kelly, K., … Wang, X. (2017). Pooled Analysis of Individual Patient Data on Concurrent Chemoradiotherapy for Stage III Non-Small-Cell Lung Cancer in Elderly Patients Compared With Younger Patients Who Participated in US National Cancer Institute Cooperative Group Studies. J Clin Oncol, 35(25), 2885–2892. https://doi.org/10.1200/JCO.2016.71.4758
Stinchcombe, Thomas E., Ying Zhang, Everett E. Vokes, Joan H. Schiller, Jeffrey D. Bradley, Karen Kelly, Walter J. Curran, et al. “Pooled Analysis of Individual Patient Data on Concurrent Chemoradiotherapy for Stage III Non-Small-Cell Lung Cancer in Elderly Patients Compared With Younger Patients Who Participated in US National Cancer Institute Cooperative Group Studies.J Clin Oncol 35, no. 25 (September 1, 2017): 2885–92. https://doi.org/10.1200/JCO.2016.71.4758.
Stinchcombe TE, Zhang Y, Vokes EE, Schiller JH, Bradley JD, Kelly K, Curran WJ, Schild SE, Movsas B, Clamon G, Govindan R, Blumenschein GR, Socinski MA, Ready NE, Akerley WL, Cohen HJ, Pang HH, Wang X. Pooled Analysis of Individual Patient Data on Concurrent Chemoradiotherapy for Stage III Non-Small-Cell Lung Cancer in Elderly Patients Compared With Younger Patients Who Participated in US National Cancer Institute Cooperative Group Studies. J Clin Oncol. 2017 Sep 1;35(25):2885–2892.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

September 1, 2017

Volume

35

Issue

25

Start / End Page

2885 / 2892

Location

United States

Related Subject Headings

  • Randomized Controlled Trials as Topic
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Male
  • Lung Neoplasms
  • Humans
  • Female
  • Clinical Trials, Phase III as Topic
  • Clinical Trials, Phase II as Topic
  • Chemoradiotherapy