Four-phase, definitive chemoradiation for a real-world (poor risk and/or elderly) patient population with locally advanced non-small cell lung cancer Journal Article


Authors: Zhou, Y. M.; Shin, J.; Jelinek, M.; Fidler, M. J.; Batus, M.; Bonomi, P. D.; Marwaha, G.
Article Title: Four-phase, definitive chemoradiation for a real-world (poor risk and/or elderly) patient population with locally advanced non-small cell lung cancer
Abstract: IntroductionWith the incorporation of modernized radiotherapy, chemotherapy, and immunotherapy, treatment outcomes have improved for patients with locally advanced, unresectable diseases. Elderly or poor performance status patients comprise more than half of non-small cell lung cancer (NSCLC) patients, but they are often underrepresented or excluded in clinical trials. Split-course concurrent chemoradiotherapy can be an effective treatment, showing good adherence and a favorable toxicity profile for unresectable, locally advanced NSCLC.MethodWe identified locally advanced NSCLC cancer patients via a single institution retrospective study. Patients were treated using a four-phase, split-course external beam radiotherapy approach with concurrent chemotherapy. The primary endpoints analyzed were completion rate, incidence, and severity of treatment-related toxicities, progression-free survival (PFS), and median overall survival (OS).ResultsThirty-nine locally advanced lung cancer patients were treated with split-course chemoradiation (CRT). The median age at diagnosis was 73 years old. Seventeen patients had an Eastern Cooperative Oncology Group (ECOG) performance score of 2. Twenty-three patients had a clinical diagnosis of chronic obstructive pulmonary disease (COPD), and 10 patients were on home oxygen at the time of diagnosis. All patients completed 6000 centigrays (cGy) of radiation, and 95% of the patients completed at least three cycles of concurrent chemotherapy. No patients experienced grade 3 to 5 acute thoracic toxicities. Overall median survival was 12.7 months, and PFS was 7.5 months.ConclusionOur retrospective analysis of 39 poor risk and/or elderly patients with locoregional NSCLC treated with concurrent CRT via a split-course regimen suggests favorable oncologic outcomes and superb treatment completion rates and toleration.
Keywords: cisplatin; chemotherapy; radiotherapy; radiation therapy; outcomes; chemoradiotherapy; palliative; concurrent; radiation-therapy; phase-iii trial; intensity modulated radiotherapy; concurrent chemoradiation therapy; geriatric medicine; advanced non-small-cell lung cancer
Journal Title: Cureus
Volume: 14
Issue: 9
ISSN: 2168-8184
Publisher: Cureus Inc.  
Date Published: 2022-09-21
Start Page: e29423
Language: English
ACCESSION: WOS:000862753100038
DOI: 10.7759/cureus.29423
PROVIDER: wos
PMCID: PMC9586742
PUBMED: 36299962
Notes: Article -- Source: Wos
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  1. Jacob Y Shin
    25 Shin