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Japanese Journal of Clinical Oncology
Year: 2010  |  Volume: 40  |  Issue: 1  |  Page No.: 54 - 59

Cisplatin and Etoposide Chemotherapy Combined with Early Concurrent Twice-daily Thoracic Radiotherapy for Limited-disease Small Cell Lung Cancer in Elderly Patients

K Okamoto, I Okamoto, K Takezawa, I Tachibana, M Fukuoka, Y Nishimura and K. Nakagawa    

Abstract: Objective

The optimal management of elderly patients with limited-disease small cell lung cancer (LD-SCLC) has not been established.

Methods

The records of elderly (≥70 years of age) patients with LD-SCLC who had been treated with etoposide and cisplatin chemotherapy with early concurrent twice-daily thoracic radiotherapy (TRT) were reviewed retrospectively.

Results

Of the 25 elderly patients with LD-SCLC identified, 12 (48%) individuals received etoposide–cisplatin chemotherapy with early concurrent twice-daily TRT. The main toxicities of this treatment regimen were hematologic, with neutropenia of Grade 4 being observed in all patients and febrile neutropenia of Grade 3 in eight patients during the first cycle of chemoradiotherapy. The toxicity of TRT was acceptable, with all patients completing the planned radiotherapy within a median of 29 days (range, 19–33). No treatment-related deaths were observed. The median progression-free survival and overall survival times were 14.2 months (95% confidence interval, 4.3–18.2) and 24.1 months (95% confidence interval, 11.3–27.2), respectively.

Conclusions

Etoposide–cisplatin chemotherapy with early concurrent twice-daily TRT was highly myelotoxic in elderly patients with LD-SCLC, although no treatment-related deaths were observed in our cohort. Prospective studies are required to establish the optimal schedule and dose of chemotherapy and TRT in such patients.

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