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Safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the Charlson Index as a predictor of survival

BACKGROUND: The best platinum-based chemotherapy regimen remains to be determined in elderly patients treated with definitive chemoradiotherapy for advanced non-small cell lung cancer (NSCLC). Predictive indexes for toxicity and survival are also needed to give the safest and most effective treatmen...

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Autores principales: Lach, Maciej, Otto, Josiane, Bondiau, Pierre-Yves, Boulahssass, Rabia, Schiappa, Renaud, Jazmati, Danny, von Krüchten, Ricarda, Martin, Nicolas, Doyen, Jérôme
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407508/
https://www.ncbi.nlm.nih.gov/pubmed/37559621
http://dx.doi.org/10.21037/jtd-23-108
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author Lach, Maciej
Otto, Josiane
Bondiau, Pierre-Yves
Boulahssass, Rabia
Schiappa, Renaud
Jazmati, Danny
von Krüchten, Ricarda
Martin, Nicolas
Doyen, Jérôme
author_facet Lach, Maciej
Otto, Josiane
Bondiau, Pierre-Yves
Boulahssass, Rabia
Schiappa, Renaud
Jazmati, Danny
von Krüchten, Ricarda
Martin, Nicolas
Doyen, Jérôme
author_sort Lach, Maciej
collection PubMed
description BACKGROUND: The best platinum-based chemotherapy regimen remains to be determined in elderly patients treated with definitive chemoradiotherapy for advanced non-small cell lung cancer (NSCLC). Predictive indexes for toxicity and survival are also needed to give the safest and most effective treatment for this population. METHODS: This is a retrospective cohort study. Patients with histologically confirmed stage IIIA, IIIB or IIIC NSCLC over 70 years of age, treated with radiotherapy and chemotherapy, were included. Patients from two cancer centers treated between 12/2006 and 08/2019 were included in the data analysis. RESULTS: Fifty-eight patients were enrolled in the study. The median age was 76.6 years [interquartile range (IQR): 71.6–83.4]. Thirty-nine patients were treated with concomitant chemoradiotherapy and 19 with a sequential strategy. The chemotherapy regimen consisted in a combination of platinum and taxanes. At a median follow-up of 52 months (IQR: 7–69), the 2-year progression-free survival (PFS) and overall survival (OS) were 35.5% and 66.9%, respectively. Male sex and a high Charlson index were identified as independent prognostic factors for worse OS. Acute grade 3–5 toxicities occurred in 34.4% of patients, including 1 grade 5 toxicity, and grade 3–4 late toxicities occurred in 17.2% of patients. In the whole cohort a high Charlson index was the only predictive factor for a higher risk of grade 3–5 acute toxicities (statistical trend in the concurrent cohort, P=0.06). CONCLUSIONS: The Charlson index correlated with toxicity and survival in elderly patients treated with chemoradiotherapy in locally advanced NSCLC. The addition of taxanes to platinum chemotherapy was safe in the present study and warrants further exploration.
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spelling pubmed-104075082023-08-09 Safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the Charlson Index as a predictor of survival Lach, Maciej Otto, Josiane Bondiau, Pierre-Yves Boulahssass, Rabia Schiappa, Renaud Jazmati, Danny von Krüchten, Ricarda Martin, Nicolas Doyen, Jérôme J Thorac Dis Original Article BACKGROUND: The best platinum-based chemotherapy regimen remains to be determined in elderly patients treated with definitive chemoradiotherapy for advanced non-small cell lung cancer (NSCLC). Predictive indexes for toxicity and survival are also needed to give the safest and most effective treatment for this population. METHODS: This is a retrospective cohort study. Patients with histologically confirmed stage IIIA, IIIB or IIIC NSCLC over 70 years of age, treated with radiotherapy and chemotherapy, were included. Patients from two cancer centers treated between 12/2006 and 08/2019 were included in the data analysis. RESULTS: Fifty-eight patients were enrolled in the study. The median age was 76.6 years [interquartile range (IQR): 71.6–83.4]. Thirty-nine patients were treated with concomitant chemoradiotherapy and 19 with a sequential strategy. The chemotherapy regimen consisted in a combination of platinum and taxanes. At a median follow-up of 52 months (IQR: 7–69), the 2-year progression-free survival (PFS) and overall survival (OS) were 35.5% and 66.9%, respectively. Male sex and a high Charlson index were identified as independent prognostic factors for worse OS. Acute grade 3–5 toxicities occurred in 34.4% of patients, including 1 grade 5 toxicity, and grade 3–4 late toxicities occurred in 17.2% of patients. In the whole cohort a high Charlson index was the only predictive factor for a higher risk of grade 3–5 acute toxicities (statistical trend in the concurrent cohort, P=0.06). CONCLUSIONS: The Charlson index correlated with toxicity and survival in elderly patients treated with chemoradiotherapy in locally advanced NSCLC. The addition of taxanes to platinum chemotherapy was safe in the present study and warrants further exploration. AME Publishing Company 2023-07-03 2023-07-31 /pmc/articles/PMC10407508/ /pubmed/37559621 http://dx.doi.org/10.21037/jtd-23-108 Text en 2023 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Lach, Maciej
Otto, Josiane
Bondiau, Pierre-Yves
Boulahssass, Rabia
Schiappa, Renaud
Jazmati, Danny
von Krüchten, Ricarda
Martin, Nicolas
Doyen, Jérôme
Safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the Charlson Index as a predictor of survival
title Safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the Charlson Index as a predictor of survival
title_full Safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the Charlson Index as a predictor of survival
title_fullStr Safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the Charlson Index as a predictor of survival
title_full_unstemmed Safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the Charlson Index as a predictor of survival
title_short Safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the Charlson Index as a predictor of survival
title_sort safety and efficacy of two-drug combination in elderly patients with locally advanced non-small cell lung cancer and validation of the charlson index as a predictor of survival
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407508/
https://www.ncbi.nlm.nih.gov/pubmed/37559621
http://dx.doi.org/10.21037/jtd-23-108
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