Chemo-radiotherapy in non-small-cell lung cancer
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In the case of elderly patients, it is important not to underestimate the risk of serious side effects.
For locally advanced non-small-cell lung cancer in stage III, concomitant chemo-radiotherapy is the standard treatment. However, in elderly patients, the therapy must be chosen with care, as the results of a study in the journal Journal of Clinical Oncology suggest.
In the overall study, the data from a total of 16 Phase II or III studies were evaluated for efficacy, but also the occurrence of side effects in patients with non-small-cell lung cancer in stage III. Data from 2,768 patients under 70 years and 832 patients from 70 years onwards were available. They all received chemo-radiotherapy with or without additional chemotherapy as an initiation.
The patients beyond the 70 had worse survival rates than the younger ones, although they had received the same therapy. It was as long as the younger ones, until the disease returned – the therapy was effective – but the older patients died earlier, as a result of tumor disease or other causes. In addition, the elderly patients suffered more severe side effects of Grade 3 or higher. They were significantly more frequently affected by severe side effects (grade 5) than younger patients. The elderly patients broke the therapy for side effects more frequently than the younger ones and switched to other treatments.
In elderly patients over the age of 70 with non-small-cell lung cancer in stage III, particular care should be taken when using chemo-radiotherapy. It is true that the treatment is effective and can successfully suppress the tumor. However, the risk of side effects and death is higher than in younger patients.