Compliance and outcome of elderly patients treated in the concurrent once-daily versus twice-daily radiotherapy (CONVERT) trial.
Authors
Christodoulou, MariannaBlackhall, Fiona H
Mistry, Hitesh
Leylek, A
Knegjens, J
Remouchamps, V
Martel-Lafay, I
Farre, N
Zwitter, M
Lerouge, D
Pourel, N
Janicot, H
Scherpereel, A
Tissing-Tan, C
Peignaux, K
Geets, X
Konopa, K
Faivre-Finn, Corinne
Affiliation
Department of Radiotherapy Related Research, The Christie NHS Foundation Trust, ManchesterIssue Date
2018
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INTRODUCTION: There is a lack of data on the efficacy and safety of concurrent chemoradiotherapy in elderly, limited-stage, patients with SCLC. METHODS: 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. RESULTS: 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). CONCLUSIONS: Concurrent chemoradiotherapy with modern radiotherapy techniques should be a treatment option for fit, older patients."Citation
Christodoulou M, Blackhall F, Mistry H, Leylek A, Knegjens J, Remouchamps V, et al.Compliance and outcome of elderly patients treated in the concurrent once-daily versus twice-daily radiotherapy (CONVERT) trial. J Thorac Oncol. 2018 Oct 31Journal
Journal of Thoracic OncologyDOI
/10.1016/j.jtho.2018.09.027PubMed ID
30391573Additional Links
https://dx.doi.org//10.1016/j.jtho.2018.09.027Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
/10.1016/j.jtho.2018.09.027
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