A pooled analysis comparing the outcomes of elderly to younger patients on nctn trials of concurrent ccrt for stage 3 NSCLC
Stinchcombe T, Zhang Y, Vokes E, Schiller J, Bradley J, Kelly K, Curran W, Schild S, Movsas B, Clamon G, Govindan R, Blumenschein G, Socinski M, Ready N, Akerley W, Cohen H, Pang H, and Wang X. A pooled analysis comparing the outcomes of elderly to younger patients on nctn trials of concurrent ccrt for stage 3 NSCLC. J Thorac Oncol 2017; 12(1):S374-S375.
J Thorac Oncol
Background: Concurrent chemoradiotherapy (CCRT) is the standard treatment (TRT) for stage 3 NSCLC. Elderly patients (pts) are common, may have increased toxicity,& poorer results from CCRT. Methods: Individual patient data (IPD) from NCTN phase 2/3 trials of CCRT for stage 3 NSCLC from 1990- 2012 was collected. We compared the overall survival (OS), progression-free survival (PFS), & adverse events (AE's) for pts age ≥70 years (yrs) (elderly) vs.(younger). Unadjusted & adjusted Hazard Ratios (HRs) for survival time & their confidence intervals (CIs) were estimated by single-predictor & multivariable Cox models. Unadjusted & adjusted Odds Ratio (OR) for AE's & their CIs were obtained from single-predictor & multivariable logistic regression models. Results: IPD from 16 trials were analyzed; 2,768 pts were younger & 832 were elderly. Median OS & PFS for elderly & younger pts are in the table. In the unadjusted & multivariable models elderly pts had worse OS (HR=1.23; 95%CI =1.13-1.35, and 1.20; 95%CI=1.10-1.32, respectively). In the unadjusted & multivariable models, elderly & younger pts had a similar PFS (HR=1.02; 95% CI=0.94-1.11 and 1.01, 95% CI=0.92-1.10, respectively). Elderly pts had a higher rate of grade ≥3 AE's in the unadjusted & multivariable models (OR=1.25; 95% CI=1.00-1.57 and 1.30; 95%CI=1.03-1.62, respectively). A lower percentage of elderly pts compared to younger completed TRT (47% and 57%, respectively; P