Evaluation of the efficacy and safety of chemotherapy for patients with wet stage IIIB/IV non-small-cell lung cancer aged 80 years old or more

Abstract

Background: Because of the number of elderly patients with NSCLC is increasing, it is becoming a public health problem world wide. In elderly patients with advanced NSCLC, mono-chemotherapy is the standard treatments. But little information is available for patients aged ≥80 regarding the management of advanced NSCLC.

Purpose: The purpose of the present study is to evaluate the efficacy and safety of chemotherapy for patients aged ≥80.

Methods: 110 patients aged ≥75 with advanced NSCLC were retrospectively reviewed. Data was collected from the electronic medical records of our hospital from January 2005 to August 2008. The patient population was divided into three age groups: patients aged ≥80 who received chemotherapy (group A), patients aged 75-79 who received chemotherapy (group B), and patients aged ≥75 who received only best supportive care (group C). Date cut-off of this study was on 20th June, 2009. We evaluated and compared the survival and the toxicity between three groups.

Results: Among 110 patients, there were 21 patients in group A, 55 patients in group B, 34 patients in group C. Among group C, there were 8 patients aged 75-79 and the main reasons for BSC were poor PS in 7 patients, and there were 26 patients aged ≥80 and the main reason for BSC were age itself in 17 patients. Response rate and disease control rate were similar in group A and group B (16.4% vs. 23.8%, and 57.1% vs. 49.1%). MST was 237 days in group A with PS 0-2 and was 232 days in group C with PS 0-2. Median PFS and MST were 86 and 237 days in group A with PS 0-2 and was 107 and 263 days in group B. Toxicity profile of group A seems to be acceptable: over grade 3 leucopenia was observed 33%; over grade 3 neutropenia was 52%; but no febrile neutropenia; over grade 3 non-hemotological toxicity was observed 14%.

Conclusion: There was no obvious difference between patients aged ≥80 and 75-79 in terms of safety and efficacy of chemotherapy. Patients aged ≥80 with advanced NSCLC who have good PS might be good candidates for the chemotherapy.