Combination of Daily Low Dose Cisplatin with Thoracic Radiation in Locally Non-Small Cell Lung Cancer for Fragile Patients: An Experimental Monocentric Serie

Lung cancer incidence in the elderly is rising over year. The standard treatment for locally non-small cell lung cancer (NSCLC) is based on a combination of chemotherapy and thoracic radiation. No standard is described or validated for patients older than 70 years.

The objective of this retrospective study was to evaluate the toxicities and the feasibility of daily cisplatin at a dose of 6 mg/m² during thoracic irradiation (66-70 Gray) in NSCLC with poor WHO performance status, and/or comorbidities. The second objective was to obtain a first estimation of survival for patients with stage III-IV.

Between 2011 and 2015, 13 patients were retrieved from the hospital database. The median age was 71.3 years, and the most frequent histologic type was squamous cell carcinoma (69%). The most frequent grade 2 adverse events were cardiac (n=3) or digestive (n=1). No pulmonary toxicity was observed. For the 10 patients with stage III-IV, the median progression free survival was 171 months. The 1-year overall survival (OS) was 90%, and the 2-years OS was 67%.

The combination of daily cisplatin with thoracic radiation is effective, and well tolerated in fragile NSCLC patients. This association should be evaluated in clinical trials.