7167 Background: Recent data have shown the benefit of adding surgery to neoadjuvant chemoradiotherapy, however no data are available for multimodality treatment including surgery in elderly patients, as well as for factors influencing toxicity, surgical resection and survival.
METHODS
patients 65 years or older, ECOG 0-1, with confirmed NSCLC and deemed unresectable for stage IIIA or IIIB disease or resectable only by a pneumonectomy, were treated according to a combined chemoradiation protocol with Carboplatin (CBCDA) or Gemcitabine (GEM). CBCDA (70 mg/m2/c.v.i.) was administered during four days the first and last week of RT, while GEM (300mg/m2) was given weekly; invoved field radiotherapy have been applied (total dose: 50.4 Gy; 1.8 Gy/day). Pulmonary, esophageal, cardiac, hematological and skin toxicities were assessed. PS, number and type of comorbidities have been recorded for all patients.
RESULTS
76 patients are evaluable; we have registered 6 (7.9%) events of hematological G3-4 toxicity and two (2.6%) for non-hematological one's. One patients experienced a toxic death. ORR to induction treatment was 72.6%. PS, number or type of comorbidities do not influence acute toxicity and response. 53 patients were judged operable, and 37 (69.8%) have been radically resected; 16 patients after pneumological and internistic evaluation have not been deemed eligible. PS and pulmonary comorbidities influenced the chance to perform surgery (P=0009 and P=0.014 respectively). Median survival was 20.3 months for all patients, and 30.4 for resected one's. Surgery was the major statistically influencing parameter for survival in the multivariate analysis.
CONCLUSIONS
elderly patients with good PS and without pulmonary comorbidities could be selected for multimodality treatment. Age, PS, number and type of comorbidities do not influences toxicity and survival, while PS and pulmonary comorbidities are a limiting factor to surgery that multivariate analysis revealed as the major statistically influencing parameters for survival . No significant financial relationships to disclose.