Effectiveness of radiation therapy alone for elderly patients with unresected stage III non-small cell lung cancer
| Autor: | Keith Sigel, Grace Mhango, Juan P. Wisnivesky, Marcelo Bonomi, Cara Bergamo, Minal Kale, Linda Lurslurchachai, Ethan A. Halm |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Oncology Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Population Article law.invention Unresected Randomized controlled trial law Carcinoma Non-Small-Cell Lung Internal medicine medicine Surveillance Epidemiology and End Results Humans Stage (cooking) education Aged Neoplasm Staging Aged 80 and over education.field_of_study business.industry Age Factors Middle Aged Tumor Burden respiratory tract diseases Radiation therapy Treatment Outcome Tolerability Female business Chemoradiotherapy SEER Program |
| Zdroj: | Lung Cancer. 82:266-270 |
| ISSN: | 0169-5002 |
| Popis: | Chemoradiotherapy is the standard of care for unresectable stage III non-small cell lung cancer (NSCLC). Elderly patients, who are often considered unfit for combined chemoradiotherapy, frequently receive radiation therapy (RT) alone. Using population-based data, we evaluated the effectiveness and tolerability of lone RT in unresected elderly stage III NSCLC patients.Using the Surveillance, Epidemiology and End Results (SEER) registry linked to Medicare records we identified 10,376 cases of unresected stage III NSCLC that were not treated with chemotherapy, diagnosed between 1992 and 2007. We used logistic regression to determine propensity scores for RT treatment using patients' pre-treatment characteristics. We then compared survival of patients who underwent lone RT vs. no treatment using a Cox regression model adjusting for propensity scores. The adjusted odds for toxicity among patients treated with and without RT were also estimated.Overall, 6468 (62%) patients received lone RT. Adjusted analyses showed that RT was associated with improved overall survival in unresected stage III NCSLC (hazard ratio [HR]: 0.76; 95% confidence interval [CI]: 0.74-0.79) after controlling for propensity scores. RT treated patients had an increased adjusted risk of hospitalization for pneumonitis (odds ratio [OR]: 89, 95% CI: 12-636), and esophagitis (OR: 8, 95% CI: 3-21).These data suggest that use of RT alone may improve the outcomes of elderly patients with unresected stage III NSCLC. Severe toxicity, however, was considerably higher in the RT treated group. The potential risks and benefits of RT should be carefully discussed with eligible elderly NSCLC patients. |
| Databáze: | OpenAIRE |
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