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1314 Concurrent chemoradiotherapy for stage III Non-small-cell lung cancer in clinical practice: Elders versus young
S192
Abstracts
performance status between 2 groups. After balancing with PSM, we selected 272 patients. Overall QoL did not show significant difference between 2 groups at baseline interview. After repeated interview, the score of global health status, physical functioning, and pain showed significantly higher in younger group (<70 years old). But other items didn’t show significant difference. Especially patients in both group felt financial difficulty increased. Conclusions: Although the elderly gastrointestinal cancer patients showed lower score in global health status, physical function and pain, they maintained relatively well-preserved functional status after curative surgery. But as time goes by, most patients felt increased financial burden. No conflict of interest. 1313 POSTER Pain profile assessment in a cohort of French old women five years after breast cancer diagnosis: Results from the ELIPPSE65 cohort ´ 3 , A.D. Bouhnik4 , M.K. Bendiane1 , M. Meresse1 , V. Laguette2 , M. Preau D. Rey1 , R. Giorgi5 . 1 INSERM UMR912/ORS PACA, Aix Marseille University, Marseille, France; 2 University Lyon2, Social Psychology Research Group GRePS EA 4163, Lyon, France; 3 University Lyon 2, Social Psychology Research Group GRePS EA 4163, Lyon, France; 4 INSERM UMR912/Institut Paoli Calmettes, Aix Marseille University, Marseille, France; 5 INSERM UMR912/APHM, Aix Marseille University, Marseille, France Background: Pain is current during first months after breast cancer (BC) treatment, but information about old women’s pain 5 years after diagnosis is not widely known. Our objective is to assess pain profile of French old women 5 years after BC diagnosis. Material and Methods: Between October 2006 and December 2008, all women included in the French National Health Insurance Fund registry for a biopsy-proven primary non metastatic BC, aged 65−80 years at diagnosis, and living in South Eastern France, were asked to participate in a cohort study including a telephone interview 60 months after diagnosis. Cluster analyses were used to identify pain profiles, based on answers to questions about pain during the last 15 days. A multinomial logistic regression was performed to assess the association between the profiles and explanatory variables such as quality of life (QOL) using the WHOQOL-BREF. Results: Among the 199 women who declared having pain during the last 15 days, median age was 71.2 at diagnosis. Three profiles were identified. The first cluster: 22.1% of the patients with severe BC-related pain, lymphoedema symptoms and analgesic treatment. The second cluster: 39.7% with non-cancer pain and analgesic treatment. The last cluster: 38.2% with moderate non-cancer pain without analgesic treatment. The first profile was compared to the others in a multinomial logistic regression. In comparison with cluster 2 and 3, cluster 1 had a worse QOL for physical and psychological dimensions, a better QOL for environmental dimension, lower incomes, and received more often chemotherapy. Conclusions: The profiles’ difference is mostly based on the way old women attributed their pain to their BC or not. The results show old women who suffered had analgesic treatment, whether they considered this pain to be associated to their BC or not. Five years after cancer diagnosis, the physical and psychological QOL of women who reported BC-related pain are lower than among those who reported non-cancer pain. No conflict of interest.
1314 POSTER Concurrent chemoradiotherapy for stage III Non-small-cell lung cancer in clinical practice: Elders versus young R. Girones Sarrio1 , J.L. Monroy2 . 1 Hospital Llu´ıs Alcany´ıs, Medical Oncology Unit, Valencia, Spain; 2 Hospital de La Ribera, Radiation Oncology, Alzira, Spain Background: For patients with a good PS and nonresectable locallyadvanced non-small cell lung cancer(LA-NSCLC), concurrent chemoradiotherapy(CRT) has been considered the standard therapy. There is currently no consensus regarding which chemotherapy is best to combine with radiotherapy in this setting. The broadest evidence comes from trials with cisplatin doublets. Lung cancer is a disease of elders, underepresented in clinical trials. Most elders are unsuitable for cisplatin-combinations(CC). Thus, only a few will be able to endure radical treatment. For elderly patients, the best treatment approach has not been determined. The treatment recommendations for elderly patients with advanced NSCLC are often conflicting. Thus, many elderly patients with advanced NSCLC will be undertreated or will not receive chemotherapy. To gain insight into the relative efficacy of CRT in clinical practice, we examined outcomes of patients with LA-NSCLC and compared outcomes by age groups. Clinical characteristics and outcomes of these patients were assessed and compared to those of their younger counterparts (<70 vs >70). Material and Methods: We performed an analysis of all stage III patients suitable for CRT at our institution from January 1, 2004 to December 15, 2014. PS 0−1. The institution’s ethical review board approved the study. All patients provided written informed consent. Results: 120 patients; 73 young (60%) and 47 elder (40%). Almost all patients were male, had smoking habit and squamous histology in both groups. Elderly patients received less active treatment, similar to a palliative approach. Median radiation dose was 60 Gy for young versus 50 for elder (p:0.048). Mediastinum was less radiated in elder group. Aged patients received less CC (71% vs 8%, p:0.0001), more carboplatin-combinations (24% vs 68%, p:0.0001) and monotherapy (5% vs 24%, p:0.0001). In terms of efficacy, it seemed that the less active treatment had not impact in Progression Free Survival (PFS) and Overall Survival (OS). PFS was similar in both groups: 21.4 months (16–26.8) versus 19.0 (12.4–25.6), p:0.519. OS had not differences by age: 27.8 (21.6–33.9) versus 23.6 (16.8–30.3), p:0.393. For elder patients, the chemotherapy schedule was unrelated to a PFS advantage. PFS at 2-years was nearly 30% for both groups. OS at 2-years was 20% and 10% at 5-years. Conclusions: Our date shown that,in clinical practice, aged patients received less intensive treatment for LA-NSCLC. But these dose reductions and less active schedules hadn’t influenced the survival rate negatively. Although CRT has routinely been reserved for younger fit patients, our results have indicated that elderly patients benefit from CRT, with schedules adjusted to age similar to a palliative intent. CRT can result in both PFS and OS benefits to elderly patients, unsuitable for cisplatin-combinations. No conflict of interest. 1317 POSTER Survival outcomes and prognostic factors in elderly patients with non-small cell lung cancer S. Park1 , J.H. Park2 , J.S. Kim2 , I.S. Choi2 , K.H. Kim2 . 1 Seoul National University College of Medicine, Department of Internal Medicine, Seoul, Korea; 2 Seoul National University Boramae Medical Center, Department of Internal Medicine, Seoul, Korea Background: The number of elderly patients diagnosed with non-small cell lung cancer (NSCLC) has increased due to the increase in life expectancy and the improvement of diagnostic techniques. Although elderly patients have decreased organ function, a large proportion of them undergo conventional chemotherapy if they have a good performance status.
Table (abstract 1313). AOR Chemotherapy all along the follow-up (%) No Yes Income (%) <1500 euros 1500–3000 euros >3000 euros Physical QOL, mean (SD) Psychological QOL, mean (SD) Environmental QOL, mean (SD
Cluster 3
Cluster 2
Cluster 1
AOR [95% CI]
p
AOR [95% CI]
17.6 31.7
1 1
41.2 36.5
1 0.3 [0.1−0.7]
0.010
41.2 31.7
1 0.3 [0.1−0.7]
0.006
36.5 15.1 9.4 50.2 (2.7) 61.0 (1.5) 67.5 (1.9)
1 1 1 1 1 1
35.1 41.9 43.7 54.5 (2.2) 59.5 (1.3) 64.0 (1.6)
1 3.2 [1.3−7.9] 9.8 [2.0–48.3] 1.1 [1.01–1.07] 1.04 [1.00–1.08] 0.95 [0.91–0.99]
0.011 0.005 0.007 0.050 0.012
28.3 43.0 46.9 63.5 (2.2) 64.5 (1.4) 71.2 (1.6)
1 3.1 [1.2−7.8] 8.4 [1.6–42.7] 1.1 [1.0−1.1] 1.04 [0.99–1.09] 0.98 [0.93–1.02]
0.020 0.010 <0.001 0.067 0.319
Abstracts
performance status between 2 groups. After balancing with PSM, we selected 272 patients. Overall QoL did not show significant difference between 2 groups at baseline interview. After repeated interview, the score of global health status, physical functioning, and pain showed significantly higher in younger group (<70 years old). But other items didn’t show significant difference. Especially patients in both group felt financial difficulty increased. Conclusions: Although the elderly gastrointestinal cancer patients showed lower score in global health status, physical function and pain, they maintained relatively well-preserved functional status after curative surgery. But as time goes by, most patients felt increased financial burden. No conflict of interest. 1313 POSTER Pain profile assessment in a cohort of French old women five years after breast cancer diagnosis: Results from the ELIPPSE65 cohort ´ 3 , A.D. Bouhnik4 , M.K. Bendiane1 , M. Meresse1 , V. Laguette2 , M. Preau D. Rey1 , R. Giorgi5 . 1 INSERM UMR912/ORS PACA, Aix Marseille University, Marseille, France; 2 University Lyon2, Social Psychology Research Group GRePS EA 4163, Lyon, France; 3 University Lyon 2, Social Psychology Research Group GRePS EA 4163, Lyon, France; 4 INSERM UMR912/Institut Paoli Calmettes, Aix Marseille University, Marseille, France; 5 INSERM UMR912/APHM, Aix Marseille University, Marseille, France Background: Pain is current during first months after breast cancer (BC) treatment, but information about old women’s pain 5 years after diagnosis is not widely known. Our objective is to assess pain profile of French old women 5 years after BC diagnosis. Material and Methods: Between October 2006 and December 2008, all women included in the French National Health Insurance Fund registry for a biopsy-proven primary non metastatic BC, aged 65−80 years at diagnosis, and living in South Eastern France, were asked to participate in a cohort study including a telephone interview 60 months after diagnosis. Cluster analyses were used to identify pain profiles, based on answers to questions about pain during the last 15 days. A multinomial logistic regression was performed to assess the association between the profiles and explanatory variables such as quality of life (QOL) using the WHOQOL-BREF. Results: Among the 199 women who declared having pain during the last 15 days, median age was 71.2 at diagnosis. Three profiles were identified. The first cluster: 22.1% of the patients with severe BC-related pain, lymphoedema symptoms and analgesic treatment. The second cluster: 39.7% with non-cancer pain and analgesic treatment. The last cluster: 38.2% with moderate non-cancer pain without analgesic treatment. The first profile was compared to the others in a multinomial logistic regression. In comparison with cluster 2 and 3, cluster 1 had a worse QOL for physical and psychological dimensions, a better QOL for environmental dimension, lower incomes, and received more often chemotherapy. Conclusions: The profiles’ difference is mostly based on the way old women attributed their pain to their BC or not. The results show old women who suffered had analgesic treatment, whether they considered this pain to be associated to their BC or not. Five years after cancer diagnosis, the physical and psychological QOL of women who reported BC-related pain are lower than among those who reported non-cancer pain. No conflict of interest.
1314 POSTER Concurrent chemoradiotherapy for stage III Non-small-cell lung cancer in clinical practice: Elders versus young R. Girones Sarrio1 , J.L. Monroy2 . 1 Hospital Llu´ıs Alcany´ıs, Medical Oncology Unit, Valencia, Spain; 2 Hospital de La Ribera, Radiation Oncology, Alzira, Spain Background: For patients with a good PS and nonresectable locallyadvanced non-small cell lung cancer(LA-NSCLC), concurrent chemoradiotherapy(CRT) has been considered the standard therapy. There is currently no consensus regarding which chemotherapy is best to combine with radiotherapy in this setting. The broadest evidence comes from trials with cisplatin doublets. Lung cancer is a disease of elders, underepresented in clinical trials. Most elders are unsuitable for cisplatin-combinations(CC). Thus, only a few will be able to endure radical treatment. For elderly patients, the best treatment approach has not been determined. The treatment recommendations for elderly patients with advanced NSCLC are often conflicting. Thus, many elderly patients with advanced NSCLC will be undertreated or will not receive chemotherapy. To gain insight into the relative efficacy of CRT in clinical practice, we examined outcomes of patients with LA-NSCLC and compared outcomes by age groups. Clinical characteristics and outcomes of these patients were assessed and compared to those of their younger counterparts (<70 vs >70). Material and Methods: We performed an analysis of all stage III patients suitable for CRT at our institution from January 1, 2004 to December 15, 2014. PS 0−1. The institution’s ethical review board approved the study. All patients provided written informed consent. Results: 120 patients; 73 young (60%) and 47 elder (40%). Almost all patients were male, had smoking habit and squamous histology in both groups. Elderly patients received less active treatment, similar to a palliative approach. Median radiation dose was 60 Gy for young versus 50 for elder (p:0.048). Mediastinum was less radiated in elder group. Aged patients received less CC (71% vs 8%, p:0.0001), more carboplatin-combinations (24% vs 68%, p:0.0001) and monotherapy (5% vs 24%, p:0.0001). In terms of efficacy, it seemed that the less active treatment had not impact in Progression Free Survival (PFS) and Overall Survival (OS). PFS was similar in both groups: 21.4 months (16–26.8) versus 19.0 (12.4–25.6), p:0.519. OS had not differences by age: 27.8 (21.6–33.9) versus 23.6 (16.8–30.3), p:0.393. For elder patients, the chemotherapy schedule was unrelated to a PFS advantage. PFS at 2-years was nearly 30% for both groups. OS at 2-years was 20% and 10% at 5-years. Conclusions: Our date shown that,in clinical practice, aged patients received less intensive treatment for LA-NSCLC. But these dose reductions and less active schedules hadn’t influenced the survival rate negatively. Although CRT has routinely been reserved for younger fit patients, our results have indicated that elderly patients benefit from CRT, with schedules adjusted to age similar to a palliative intent. CRT can result in both PFS and OS benefits to elderly patients, unsuitable for cisplatin-combinations. No conflict of interest. 1317 POSTER Survival outcomes and prognostic factors in elderly patients with non-small cell lung cancer S. Park1 , J.H. Park2 , J.S. Kim2 , I.S. Choi2 , K.H. Kim2 . 1 Seoul National University College of Medicine, Department of Internal Medicine, Seoul, Korea; 2 Seoul National University Boramae Medical Center, Department of Internal Medicine, Seoul, Korea Background: The number of elderly patients diagnosed with non-small cell lung cancer (NSCLC) has increased due to the increase in life expectancy and the improvement of diagnostic techniques. Although elderly patients have decreased organ function, a large proportion of them undergo conventional chemotherapy if they have a good performance status.
Table (abstract 1313). AOR Chemotherapy all along the follow-up (%) No Yes Income (%) <1500 euros 1500–3000 euros >3000 euros Physical QOL, mean (SD) Psychological QOL, mean (SD) Environmental QOL, mean (SD
Cluster 3
Cluster 2
Cluster 1
AOR [95% CI]
p
AOR [95% CI]
17.6 31.7
1 1
41.2 36.5
1 0.3 [0.1−0.7]
0.010
41.2 31.7
1 0.3 [0.1−0.7]
0.006
36.5 15.1 9.4 50.2 (2.7) 61.0 (1.5) 67.5 (1.9)
1 1 1 1 1 1
35.1 41.9 43.7 54.5 (2.2) 59.5 (1.3) 64.0 (1.6)
1 3.2 [1.3−7.9] 9.8 [2.0–48.3] 1.1 [1.01–1.07] 1.04 [1.00–1.08] 0.95 [0.91–0.99]
0.011 0.005 0.007 0.050 0.012
28.3 43.0 46.9 63.5 (2.2) 64.5 (1.4) 71.2 (1.6)
1 3.1 [1.2−7.8] 8.4 [1.6–42.7] 1.1 [1.0−1.1] 1.04 [0.99–1.09] 0.98 [0.93–1.02]
0.020 0.010 <0.001 0.067 0.319