Pınar ÖZDEMİR, Erman ÖZDEMİR, Serap YADİGAR, Erdoğan ÖZDEMİR
Southern Clinics of Istanbul Eurasia - 2026;37(3):294-300
Objective: Concurrent chemoradiotherapy (CRT) is the standard treatment for patients with unresectable stage III non-small cell lung cancer (NSCLC). However, data on its efficacy and safety in elderly populations are limited. This study aimed to evaluate survival outcomes, treatment response, and toxicity profiles of CRT with three different chemotherapy regimens in elderly patients with stage III NSCLC. Methods: We retrospectively analyzed 75 patients aged >=65 years with unresectable stage IIIA-IIIB NSCLC who received CRT between October 2006 and October 2014. Patients were treated with one of the following regimens: Carboplatin plus paclitaxel (PC; n=41), cisplatin plus docetaxel (PD; n=21), or cisplatin plus etoposide (PE; n=13). Radiotherapy was administered concurrently in all cases (60 Gy in 30 fractions). Clinical endpoints included overall survival (OS), progression-free survival (PFS), treatment response (per RECIST v1.1), and toxicity (per NCI-CTCAE v4.03). Results: Median OS was 31.6 months in the PE group, 20.0 months in the PC group, and 13.7 months in the PD group (p=0.322). Median PFS was 19.8, 10.6, and 10.9 months for PE, PC, and PD groups, respectively (p=0.643). Disease control rates-defined as complete response (CR), partial response (PR), and stable disease (SD)-were 92.3% (PE), 75.6% (PC), and 71.4% (PD) (p=0.279). Neuropathy was most common in the PC group (20%), while hematologic toxicities occurred more frequently in the PD group. Chemotherapy discontinuation was significantly higher in patients with Eastern Cooperative Oncology Group (ECOG) performance status of 2 (p=0.012). Conclusions: In elderly patients with inoperable stage III NSCLC, all three CRT regimens demonstrated acceptable efficacy and safety profiles. Although not statistically significant, the PE regimen was associated with numerically better survival outcomes and higher disease control rates, suggesting it may be a favorable option for selected elderly patients.
