Treatment of limited-stage small cell lung cancer in the elderly, chemotherapy vs. sequential chemoradiotherapy vs. concurrent chemoradiotherapy: that’s the question

Cesare Gridelli, Francesca Casaluce, Assunta Sgambato, Fabio Monaco, Cesare Guida

Abstract

Chemotherapy is the mainstay of the treatment in limited disease (LD) and extended disease (ED) small cell lung cancer (SCLC) patients, while concurrent chemoradiotherapy (CRT) is the standard of care in healthy patients with LD. However, this intensive treatment is associated with significantly more toxicity in the subset of patients aged 70 years or more. To date, most of available data concerning CRT in elderly derived from retrospective analyzes, usually conducted on small samples of patients, poorly representative of this population. Modern CRT appears to confer a survival benefit compared to chemotherapy alone in a recent retrospective analysis conducted on elderly patients with LD-SCLC. Age alone should not be a contraindication for multimodality treatment in this subset of patients.