A phase II study of concurrent accelerated hyperfractionated radiotherapy and carboplatin/oral etoposide for elderly patients with stage III non-small-cell lung cancer

Purpose: To investigate feasibility, toxicity, and efficacy of accelerated hyperfractionated radiation therapy and concurrent carboplatin/oral etoposi de in elderly (> 70 years) patients with stage III non-small-cell lung canc er, Methods and Materials: Between January 1988 and June 1993, a total of 58 pa tients entered a phase II study. Carboplatin (400 mg/m(2)) was given intrav enously on days 1 and 29, and etoposide (50 mg/m(2)) was given orally on da ys 1-21 and 29-42. Accelerated hyperfractionated radiotherapy was administe red starting on day 1, with a total dose of 51 Gy in 34 fractions over 3.5 weeks. Results: In 55 evaluable patients, the complete response rate was 27% and t he overall response rate was 65%. For the 55 patients, the median survival time was 10 months, and the 1-, 2-, and 5-year survival rates were 45%, 24% , and 9.1%, respectively. The median time until relapse was 8 months and th e 1-, 2-, and 5-year relapse-free survival rates were 45%, 20%, and 9.1%, r espectively. The median time to local recurrence was 14 months and the 5 ye ar local control rate was 13%; the median time to distant metastasis was 18 months and the 5-year distant metastasis-free rate was 15%. Hematological, esophageal, and bronchopulmonary acute grade 3 or 4 toxicities were observ ed in 22%, 7%, and 4% of the patients, respectively. There was no grade 5 t oxicity or late grade greater than or equal to 3 toxicity, Conclusion: Concurrent accelerated hyperfractionated radiotherapy and carbo platin/oral etoposide produced relatively low and acceptable toxicity. The survival results appeared to be comparable to those obtained in nonelderly patients with stage III non-small-cell lung cancer treated by full-dose rad iation. (C) 1999 Elsevier Science Inc.