Author of

• 12573

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  P3.09 - Poster Session 3 - Combined Modality (ID 214)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Combined Modality
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12579

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    P3.09-006 - Outcomes of Elderly Patients with Locally-Advanced Non-Small Cell Lung Cancer (LA-NSCLC) Treated with Radiation +/- Chemotherapy at the Ottawa Hospital Cancer Centre (ID 1331)

    09:30 - 09:30  |  Author(s): B.D. Healy
    • Abstract

    Background
    Concurrent chemoradiation (C-CRT) is standard therapy for fit patients with unresectable, LA-NSCLC. We evaluated outcomes of patients treated with curative intent at our centre for quality assurance, and to compare outcomes between elderly (≥75) and younger patients.

    Methods
    Patients with stages IIIA/ IIIB NSCLC from 2002 to 2008 were identified, and those planned for curative-intent radiation (minimum 50Gy) included, irrespective if therapy was actually completed. Charts were reviewed for patient demographics, baseline prognostic factors, treatments planned and administered, hospitalizations and outcomes. Multivariable analyses were performed to determine factors associated with survival.

    Results
    329 patients were included: median age 66 (range 40-89), 60% male, 15% ECOG 2+, 60% IIIB, 35% weight loss >5%. 20% (66/329) were ≥75. C-CRT, sequential CRT and radiation alone were delivered in 85%, 5%, and 10% of cases, respectively; the elderly were less likely to receive C-CRT (61% vs. 91%). Median survival (all patients) was 18.4 months; for < and ≥75 cohorts, MS were 20.8 and 16.4 months (p=0.0533). 3 and 5 year OS (all patients) were 29% and 17%; for the < and ≥75 cohorts values were 31/21% and 19/8%. Elderly patients had lower treatment-related hospitalization (6% vs. 20%) and death (2% vs. 5%). Radiation compliance was equivalent however chemotherapy completion was higher in younger patients (78% vs. 45%). In multivariate analysis, age ≥75 (HR=1.68, 95% CI 1.03-2.75, p=0.038), female gender (HR=0.60, 95% CI 0.41-0.87, p=0.008), and completion of radiation therapy (HR=0.39, 95% CI 0.25-0.62, p<0.0001) were independent predictors of outcome. Figure 1

    Conclusion
    Outcomes of patients with LA-NSCLC offered curative therapy at the Ottawa Hospital Cancer Centre are comparable to those obtained in clinical trials of C-CRT, despite a more unselected population with a higher proportion of poor prognostic features. Those ≥75 were less likely to be offered C-CRT and were less likely to complete planned chemotherapy. However fit patients ≥75 offered radical therapy still have reasonable MS and 3-year OS.