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Takeshita J, Masago K, Fujita S, Hata A, Kaji R, Kawamura T, Tamai K, Matsumoto T, Nagata K, Otsuka K, Nakagawa A, Otsuka K, Tomii K, Shintani T, Takayama K, Kokubo M, Katakami N. Weekly administration of paclitaxel and carboplatin with concurrent thoracic radiation in previously untreated elderly patients with locally advanced non-small-cell lung cancer: A case series of 20 patients. Mol Clin Oncol 2014; 2:454-460. [PMID: 24772317 DOI: 10.3892/mco.2014.249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 01/23/2014] [Indexed: 12/28/2022] Open
Abstract
Elderly patients with stage III non-small-cell lung cancer (NSCLC) are frequently underrepresented in clinical trials that evaluate chemoradiotherapy, due to their poor functional status, coexisting illnesses and limited life expectancy. The Japan Clinical Oncology Group 0301 trial (JCOG0301) was the first study to demonstrate that thoracic radiation therapy (TRT) with daily low-dose carboplatin may improve the outcome of elderly patients with stage III NSCLC. However, the efficacy and safety profiles of chemoradiotherapy, including platinum doublets, have not been clearly determined in this patient population. We retrospectively assessed the efficacy and toxicity of weekly paclitaxel in combination with carboplatin and concurrent TRT in patients aged ≥75 years with previously untreated locally advanced NSCLC. Between February, 2004 and July, 2013, we collected the data of 20 patients treated with weekly paclitaxel and carboplatin for 6 weeks and concurrent TRT. The objective response rate was 90%, the disease control rate was 95%, the median progression-free survival was 8.63 months [95% confidence interval (CI): 5.7-16.7] and the median overall survival (OS) was 16.1 months (95% CI: 10.7-41.6). There were no grade 4 hematological or non-hematological toxicities and no reported treatment-related deaths. Therefore, platinum doublet therapy in combination with TRT did not provide a clinically significant survival benefit in our population of elderly patients with locally advanced NSCLC. However, the present study demonstrated the good feasibility and safety of this regimen. Further prospective clinical trials are required to evaluate the efficacy and safety of platinum doublet with TRT in elderly patients.
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Affiliation(s)
- Jumpei Takeshita
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Katsuhiro Masago
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Shiro Fujita
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Akito Hata
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Reiko Kaji
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Takahisa Kawamura
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Koji Tamai
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Takeshi Matsumoto
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Kazuma Nagata
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Kyoko Otsuka
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Atsushi Nakagawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Kojiro Otsuka
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Takashi Shintani
- Division of Radiation Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Kenji Takayama
- Division of Radiation Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Masaki Kokubo
- Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Nobuyuki Katakami
- Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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