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Japanese Journal of Clinical Oncology Advance Access published online on October 16, 2009
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyp137
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© The Author (2009). Published by Oxford University Press. All rights reserved

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

Kunio Okamoto1, Isamu Okamoto1, Ken Takezawa1, Izumi Tachibana2, Masahiro Fukuoka3, Yasumasa Nishimura2 and Kazuhiko Nakagawa1

1 Department of Medical Oncology, Kinki University School of Medicine
2 Department of Radiation Oncology, Kinki University School of Medicine
3 Department of Medical Oncology, Kinki University School of Medicine, Sakai Hospital, Osaka, Japan

For reprints and all correspondence: Isamu Okamoto, Department of Medical Oncology, Kinki University School of Medicine, 377-2 Ohno-higashi, Osaka-Sayama, Osaka 589-8511, Japan. E-mail: chi-okamoto{at}dotd.med.kindai.ac.jp

Received August 7, 2009; accepted September 13, 2009

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.

Key Words: elderly • small cell lung cancer • chemoradiotherapy • cisplatin • etoposide • concurrent thoracic radiotherapy


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