While most cases of lung cancer occur after the age of 65, few comprehensive studies have been done on determining the best treatment.
New research on patients over 65 shows that adding chemotherapy to the traditional radiation treatment for inoperable lung cancer significantly improves survival rates.
"Ask your oncologist about combination therapy."
Researchers from Japan designed a study to understand how to more effectively fight lung cancer, given the large difference in mortality in comparison to other cancers. While the more aggressive treatment had significant side effects, on average patients with combination therapy gained five months.
The study design assigned 200 patients with inoperable non-small-cell lung cancer who were over the age of 71 to either chemoradiotherapy with carboplatin or radiotherapy alone.
At follow up, combination therapy had a better effect on the cancer than radiation alone, with an observed patient survival of 22.4 months in comparison to 16.9 months, on average.
Side effects from the chemotherapy were significant, with more than half experiencing severe effects including signs of immune system failure. The radiation only group did not have similarly severe side effects from the treatment.
The authors of the study concluded their paper by stating,"Combined treatment is feasible and tolerable in elderly patients with locally advanced NSCLC and should be considered for this population."
An accompanying editorial published alongside the study expressed reservations about the sample size and a desire for randomized trials before drawing conclusions.
Juan Wisnivesky, MD, and Gary Strauss, MD, wrote a statement saying that, "The unexpectedly large survival advantage for concurrent chemoradiation raises concerns about the representativeness of the sample of elderly patients."
Dr. Wisnivesky and Dr. Strauss continued to explain the possible problems with the study, saying,"Results might not be valid for the broader population of older patients with stage III NSCLC... Additional validation of the present findings is needed before concurrent chemoradiation can be considered standard of care in elderly patients."
The study was published in the journal The Lancet on May 22, 2012.
Funding for the study was provided by the Ministry of Health, Labour, and Welfare of Japan.