Compliance and Outcome of Elderly Patients Treated in the Concurrent Once-Daily Versus Twice-Daily Radiotherapy (CONVERT) Trial
Christodoulou, M. (The Christie NHS Foundation Trust)
Blackhall, Fiona (University of Manchester)
Mistry, H. (University of Manchester)
Leylek, A. (CancerCare Manitoba)
Knegjens, J. (The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital)
Remouchamps, V. (CHU UCL Namur. site Ste Elisabeth)
Martel-Lafay, I. (Centre Léon Bérard)
Farré, Núria (Institut d'Investigació Biomèdica Sant Pau)
Zwitter, M. (Institute of Oncology)
Lerouge, D. (Centre François Baclesse (Caen, França))
Pourel, N. (Institut Sainte-Catherine)
Janicot, H. (CHU Gabriel Montpied)
Scherpereel, A. (Hospital of the University (CHRU) of Lille)
Tissing-Tan, C. (Radiotherapiegroep)
Peignaux, K. (Georges Francois LECLERC Center)
Geets, X. (Cliniques universitaires Saint-Luc. MIRO-IREC-UCL)
Konopa, K. (Medical University of Gdansk)
Faivre-Finn, C. (University of Manchester)

Date:	2019
Abstract:	There is a lack of data on the efficacy and safety of concurrent chemoradiotherapy in elderly, limited-stage, patients with SCLC. We compared outcomes of patients 70 years of age or older versus younger patients within the Concurrent Once-daily Versus twice-daily RadioTherapy (CONVERT) trial. Patients were randomized to receive 45 Gy/30 twice-daily fractions/19 days or 66 Gy/33 once-daily fractions/45 days concurrently with platinum-based chemotherapy. Overall survival and progression-free survival were evaluated using Kaplan-Meier methodology and Cox proportional hazards regression. Of 547 patients randomized between April 2008 and November 2013, 57 did not receive protocol treatment and were excluded. Of the 490 patients included, 67 (14%) were 70 years of age or older (median age: 73 years; range: 70-82). Fewer older patients received the optimal number of radiotherapy fractions (73% versus 85%; p = 0. 03); however, chemotherapy compliance was similar in both groups (p = 0. 24). Neutropenia grade 3/4 occurred more frequently in the elderly (84% versus 70%; p = 0. 02) but rates of neutropenic sepsis (4% versus 7%; p = 0. 07) and death (3% versus 1. 4%; p = 0. 67) were similar in both groups. With a median follow-up of 46 months; median survival in the elderly versus younger groups was 29 (95% confidence interval [CI]: 21-39) versus 30 months (95% CI: 26-35), respectively; (hazard ratio: 1. 15, 95% CI: 0. 84-1. 59; p = 0. 38). Median time to progression in the elderly versus younger groups was 18 months (95% CI: 13-31) versus 16 months (95% CI: 14-19), respectively (hazard ratio: 1. 04, 95% CI: 0. 76-1. 41; p = 0. 81). Concurrent chemoradiotherapy with modern radiotherapy techniques should be a treatment option for fit, older patients.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Chemotherapy ; Elderly ; Limited stage ; Radiotherapy ; SCLC
Published in:	Journal of Thoracic Oncology, Vol. 14 Núm. 1 (january 2019) , p. 63-71, ISSN 1556-1380

DOI: 10.1016/j.jtho.2018.09.027
PMID: 30391573

9 p, 707.5 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles