Outcomes of Multimodal Treatment in Elderly Patients with Localized Non-Small Lung Cancer from a Radiation Oncology Point of View: Special Focus on Low-Dose Cisplatin.

Autor:	Alt NJ; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Muster J; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Ziegler DA; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Bendrich S; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Donath S; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Hille A; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Anczykowski MZ; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Zwerenz CM; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Braulke F; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., von Hammerstein-Equord A; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany.; Department of Cardio-Thoracic and Vascular Surgery, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany., Overbeck TR; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany.; Department of Hematology and Medical Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany., Treiber H; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany.; Department of Hematology and Medical Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany., Guhlich M; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., El Shafie R; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Rieken S; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Leu M; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany., Dröge LH; Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.; Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Von-Bar-Str. 2/4, 37075 Göttingen, Germany.
Jazyk:	angličtina
Zdroj:	Cancers [Cancers (Basel)] 2024 Jan 11; Vol. 16 (2). Date of Electronic Publication: 2024 Jan 11.
DOI:	10.3390/cancers16020327
Abstrakt:	Identification of the optimal treatment strategy is challenging in elderly with localized non-small cell lung cancer (NSCLC). Concurrent chemotherapy with low-dose cisplatin represents an option for elderly. Outcomes (1) in elderly (≥70 years, n = 158) vs. younger patients ( n = 188) and (2), independently of age, in definitive radiochemotherapy, with low-dose cisplatin ( n = 125) vs. cisplatin/vinorelbine ( n = 76) were studied. Elderly included more males, had a lower Karnofsky index, more comorbidities, and lower stages. Low-dose cisplatin patients (vs. cisplatin/vinorelbine) had higher age, more comorbidities, and lower stages. We observed reduced dermatitis and dysphagia and increased anemia and thrombocytopenia in elderly vs. younger patients, without increased ≥grade 3 toxicities. Low-dose cisplatin was less toxic than cisplatin/vinorelbine. Survival outcomes were lower in elderly vs. younger and comparable between low-dose cisplatin and cisplatin/vinorelbine. In elderly, gender, Karnofsky index, stage, and multimodal treatment (including additional surgery/systemic therapy) were identified as prognostic factors. In conclusion, we found evidence for an acceptable toxicity profile and the need for improvement of outcomes in elderly with localized NSCLC. Multimodal strategies (including additional surgery/systemic treatment) showed favorable outcomes and should be reasonably considered in elderly who are deemed fit enough. Low-dose cisplatin should be discussed on an individual basis due to favorable toxicity and outcomes.
Databáze:	MEDLINE
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