Concomitant Radio-chemotherapy in the Elderly

Inclusion criteria

• Age ≥ 70 years
• Independent patients (based on the score of geriatric frailty: IADL = 0, ADL = 0, no geriatric syndrome, low comorbidity (comorbidity index of Charlson to 3 or 4), depression score 0-1)
• Performance Status (ECOG) ≤ 1
• Weight loss <10% of usual weight in the last 3 months
• Life expectancy greater than 12 weeks
• Hematologic function: neutrophils> 1.5 x 10**9 / l, hemoglobin> 9.5 g / dl, platelets > 100 x 10**9 / l)
• Renal function: creatinine clearance ≥ 50 ml / min calculated by the formula of MDRD
• Normal liver function: bilirubin < Limit of Normal (ULN), SGOT and / or SGPT <2.5 x UNL
• Respiratory Function: FEV ≥ 40% predicted, PaO2 ≥ 60 mm Hg, KCO ≥ 60% predicted
• Patient affiliated to a social security regimen or beneficiary of such regimen
• Informed consent signed

The disease

• Pathological anatomy: CBP non-small cell (squamous cell carcinoma, adenocarcinoma, large cell carcinoma, undifferentiated carcinoma) histologically or cytologically proven
• Stage IIIAN2 considered inoperable stage IIIB
• Presence of at least one measurable target
• Delay at least three weeks between surgery and initiation of treatment
• No prior treatment with chemotherapy or radiotherapy for lung cancer

Exclusion criteria

• Age < 70 years
• Performance Status (ECOG) ≥ 2
• Hematologic function: neutrophils <1.5 x 10**9 / l, hemoglobin <9.5 g / dl, platelets <100 x 10**9 / l)
• Renal function: creatinine clearance <50 ml / min calculated by the formula of MDRD
• Hepatic: bilirubin> Upper Limit of Normal (ULN), SGOT and / or SGPT> 2.5 x ULN
• Respiratory Function: FEV <40% predicted, KCO <60% predicted, PaO2 <60 mmHg
• Peripheral neuropathy grade> 1
• Unstable cardiac pathology requiring treatment (heart failure, angor of effort, arrhythmia) or previous myocardial infarction older than 12 months
• Deafness not paired or deafness requiring major achievement of an audiogram-cons may indicate taking cisplatin
• Neurological or psychiatric disorders prohibiting the understanding of the test
• Previous history of cancer except basal cell cancer, carcinoma in situ of the cervix treated or any other cancer treated with surgery alone or radiotherapy alone extra-thoracic recurrence-free 5 years
• Significant malabsorption syndrome or disease affecting the functioning of the gastrointestinal tract

The disease

• Pathological anatomy: Bronchioloalveolar carcinoma, neuroendocrine carcinoma, small cell carcinoma
• Metastatic disease
• Pleural drain
• Carcinomatous lymphangitis
• Operable Cancer
• Previously treated for lung cancer disease: radiotherapy, chemotherapy, hormonal therapy, endobronchial suctioning older less than eight days