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Type: Journal article
Title: Quality of life, geriatric assessment and survival in elderly patients with non-small-cell lung cancer treated with carboplatin-gemcitabine or carboplatin-paclitaxel: NVALT-3 a phase III study
Author: Biesma, B.
Wymenga, A.
Vincent, A.
Dalesio, O.
Smit, H.
Stigt, J.
Smit, E.
van Felius, C.
van Putten, J.
Slaets, J.
Groen, H.
Citation: Annals of Oncology, 2011; 22(7):1520-1527
Publisher: Oxford University Press (OUP)
Issue Date: 2011
ISSN: 0923-7534
Statement of
B. Biesma, A. N. M. Wymenga, A. Vincent, O. Dalesio, H. J. M. Smit, J. A. Stigt, E. F. Smit, C. L. van Felius, J. W. G. van Putten, J. P. J. Slaets and H. J. M. Groen, on behalf of the Dutch Chest Physician Study Group
Abstract: Background: Elderly patients with advanced non-small-cell lung cancer (NSCLC) may derive similar benefit from platinum-based chemotherapy as younger patients. Quality of life (QoL) and comprehensive geriatric assessment (CGA) is often advocated to assess benefits and risks. Patients and methods: A total of 181 chemotherapy-naive patients [≥70 years, performance score (PS) of 0–2] with stage III–IV NSCLC received carboplatin and gemcitabine (CG) (n = 90) or carboplatin and paclitaxel (CP) (n = 91) every 3 weeks for up to four cycles. Primary end point was change in global QoL from baseline compared with week 18. Pretreatment CGA and mini geriatric assessment during and after treatment were undertaken. A principal component (PC) analysis was carried out to determine the underlying dimensions of CGA and QoL and subsequently related to survival. Results: There were no changes in QoL after treatment. The number of QoL responders (CG arm, 12%; CP arm, 5%) was not significantly different. CGA items were only associated with neuropsychiatric toxicity. Quality-adjusted survival was not different between treatment arms. The PC analysis derived from nine CGA, six QoL and one PS score indicated only one dominant dimension. This dimension was strongly prognostic, and physical and role functioning, Groningen Frailty Indicator and Geriatric Depression Scale were its largest contributors. Conclusions: Paclitaxel or gemcitabine added to carboplatin did not have a differential effect on global QoL. CGA was associated with toxic effects in a very limited manner. CGA and QoL items measure one underlying dimension, which is highly prognostic.
Keywords: elderly; geriatric assessment; NSCLC; phase III; platinum-based chemotherapy; quality of life
Description: Presented in part as a poster at the 43rd Annual Meeting of the American Society of Clinical Oncology, 1–5 June 2007, Chicago, IL. Presented in part as a poster at the 12th World Conference on Lung Cancer, 2–6 September 2007, Seoul, South Korea. Registered at, NTR 925.
Rights: © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email:
DOI: 10.1093/annonc/mdq637
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