Supplemental table 1 Eligibility criteria

The inclusion criteria were as follows:

(1) pathologically proven SCLC

(2) age of 76 years or more

(3) no prior anticancer therapy

(4) PS of 0–2 on the Eastern Cooperative Oncology Group (ECOG) scale

(5) presence of evaluable lesions

(6) adequate reserves of

hematological function

white blood cell [WBC] count ≥ 4,000/mm3

neutrophil count ≥ 2,000/mm3

hemoglobin level ≥ 9.5 g/dl

platelet count ≥10×104/mm3

renal function

serum creatinine ≤ 1.5 mg/dl

hepatic function

total bilirubin ≤ 1.5 mg/dl

serum transaminases 2.5 x upper limit of normal range

pulmonary function

PaO2 ≥ 60 Torr, at rest

(7) acquisition of a written informed consent

The exclusion criteria were as follows:

(1) serious and uncontrollable concomitant systemic disorder (including heart disease, infection, and diabetes mellitus)

(2) radiographic signs of interstitial lung disease

(3) pleural or pericardial effusion requiring drainage

(4) history of severe drug allergy

(5) active second malignancy

SCLC: small cell lung cancer, PS: performance status

Supplemental Table 2. Clinical demographics of the 5 patients with ED-SCLC

Median age, years (range) 79 (77-83)

Gender (male / female) 3 (60%) / 2 (40%)

Staging (IIIB / IV) 1 (20%) / 4 (80%)

ECOG PS (0-1 / 2) 5 (100%) / 0 (0%)

Smoking (never / ever / unknown) 2 (40%) / 2 (40%) / 1 (20%)

Median Charlson score (range) 3 (2-3)

ECOG: Eastern Cooperative Oncology Group, PS: performance status

Supplemental table 3. Efficacy stratified by several clinical factors

n ORR MST (m) PFS (m)

Overall 22 15 (68.2%) 22.2 9.1

Age < 80 12 7 (58.3%) 22.2 8.3

≥ 80 10 8 (80.0%) 15.7 9.1

PS 0 11 7 (63.6%) 29.5 9.1

1 / 2 11 8 (72.7%) 15.7 10.1

Smoking Never 4 3 (75.0%) 15.7 13

Status Ever 18 12 (66.7%) 22.2 7.2

Gender Female 3 1 (33.3%) 29.5 12.7

Male 19 14 (73.7%) 22.2 9.1

Charlson 0-2 9 6 (66.7%) 29.5 9.1

Score ≥ 3 13 9 (69.2%) 20.8 13

Stage I-II 6 4 (66.7%) 31.9 13

III 16 11 (68.8%) 20.8 7.2

N factor N0 - N1 7 4 (57.1%) 35.4 13

N2 - N3 15 11 (73.3%) 15.7 8.3

T factor T1 - T2 13 9 (69.2%) 29.5 9.1

T3 - T4 9 6 (66.7%) 20.8 10.1

ORR: overall response rate, MST: median survival time, PFS: progression free survival, PS: performance status

Supplemental Table 4. Prior relevant clinical chemoradiotherapeutic trials in elderly patients with small cell lung cancer

Regimen / TRT / stage / n / Age / ORR
(%) / MST
(m) / MPFS
(m) / Toxicity: Grade ≥ 3 (%)
Neu / Thro / Ane / FN / Eso / Pneu
Okamoto / CDDP
+ETP / early concurrent twice-daily (45Gy) / LD / 12 / ≥ 70 / 100 / 24.1 / 14.2 / 100 / 33 / 33 / 67 / 0 / 8
Murata / CBDCA
+CPT-11 / - / LD / 8 / ≥ 70 / 87.5 / 26 / 12 / 83 / 46 / 60 / - / - / -
- / ED / 22 / 81.8 / 11 / 6
Inoue / CBDCA
+AMR / Sequential / LD / 15 / ≥ 70 / 89 / 18.6 / 5.8 / 97 / 28 / 28 / 17 / - / 0
- / ED / 21
Tada / CBDCA
+ETP / Sequential (40Gy) / LD / 8 / ≥ 76 / 88 / 7.3 / - / 76 / 24 / 6 / - / 0 / 6
- / ED / 9 / 67 / 5.2 / -
Current trial / CDDP
+TOP / Sequential (45Gy) / LD / 22 / ≥ 76 / 68.2 / 22.2 / 9.1 / 95.5 / 50.0 / 36.4 / 31.8 / 0 / 18.1

CDDP: cisplatin, ETP: etoposide, CPT-11: irinotecan, CBDCA: carboplatin, AMR: amrubicin, TOP: topotecan, TRT: thoracic radiotherapy, ORR: objective response rate, MST: median survival time, MPFS: median progression free survival, Neu: neutropenia, Thro: thrombocytopenia, Ane: anemia, FN: febrile neutropenia, Eso: esophagitis, Pneu: pneumonitis.