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Annals of Oncology Advance Access published online on August 20, 2008
Annals of Oncology, doi:10.1093/annonc/mdn559
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Eligibility for concurrent chemotherapy and radiotherapy of locally advanced lung cancer patients: a prospective, population-based study

D. De Ruysscher1,*, A. Botterweck2, M. Dirx2, M. Pijls-Johannesma4, R. Wanders4, M. Hochstenbag3, A. -M. C. Dingemans3, G. Bootsma5, W. Geraedts6, J. Simons8, C. Pitz7 and P. Lambin1

1 Department of Radiation Oncology (Maastro Clinic), GROW Research Institute, University Medical Center Maastricht
2 Maastricht Cancer Registry, Comprehensive Cancer Centre Limburg (IKL)
3 Department of Pulmonology, University Medical Center Maastricht
4 Maastro Clinic, Maastricht
5 Department of Pulmonology, Atrium Medical Center, Heerlen
6 Department of Lung Diseases, Maasland Hospital, Sittard
7 Department of Lung Diseases, Laurentius Hospital, Roermond
8 Department of Lung Diseases, Sint Jans Gasthuis, Weert, The Netherlands

* Correspondence to: Dr D. K. M. De Ruysscher, Department of Radiation Oncology (Maastro Clinic), University Medical Center Maastricht, GROW Research Institute, Dr Tanslaan 12, 6229 ET Maastricht, The Netherlands. Tel: +31-88-445-57-00; Fax: +31-88-445-57-73; E-mail: dirk.deruysscher{at}maastro.nl

Background: Patients with stage III non-small-cell lung cancer (NSCLC) and limited disease small-cell lung cancer are excluded from concurrent chemoradiation mostly on the basis of comorbidity and age. The purpose of this prospective study was to get insight in what proportion of patients with locally advanced lung cancer would be suitable for concurrent chemoradiation.

Patients and methods: From 2002 to 2005, all patients with a pathological diagnosis of lung cancer and with locally advanced disease in the Maastricht Cancer Registry, the Netherlands, comorbidity were prospectively assessed. Patients were regarded as noneligible for concurrent chemoradiation if they had one or more important comorbidity or were 75 years or older.

Results: In all, 711 patients were included, 577 with NSCLC and 134 with SCLC. Overall, 166 patients (23.3%) were 75 years or older. Of the 526 patients <75 years, comorbidities were as follows: 278 (52.9%) 0, 188 (35.7%) 1, and 56 (11.4%) 2 or more. In all, 408/686 (59%) of the whole patient group were considered as ineligible for concurrent chemoradiation.

Conclusions: More than half of patients with stage III lung cancer were theoretically not eligible for concurrent chemoradiation. Less toxic alternatives are needed for these patients.

combined modality treatment, comorbidity, concurrent chemotherapy and radiotherapy, lung cancer, Maastricht Cancer Registry

Received for publication May 15, 2008. Revision received July 11, 2008. Accepted for publication July 14, 2008.


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