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Management of elderly patients with advanced non-small cell lung cancer: a single-center experience

Martin Früh, H Besrour, Silke Gillessen, Markus Joerger, Felicitas Hitz, A Savidan, Thomas Cerny & S Ess

abstract Background: Optimal management of elderly patients (≥70 years) with non-small cell lung cancer (NSCLC) remains debatable. We compared survival and treatment of advanced NSCLC between elderly and younger patients. Methods: From the cancer registry, we identified 188 patients treated with chemotherapy for stage IV NSCLC. Patient characteristics, survival, toxicity, chemotherapy regimen and response were compared between age groups (patients 50-69 vs. ≥70 years). Results: There were 96 young and 92 elderly patients. The majority were male (70%) and had adenocarcinoma (53%). More elderly had an ECOG performance status >1 (59 vs. 42%, p = 0.04). Median survival was longer for young patients (11.5 vs. 10.8 months, hazard ratio, HR 1.43, p = 0.04). Patients ≥75 years had a significantly worse outcome compared to the young and patients aged 70-74 years (11.5 vs. 12.8 vs. 7.7 months, HR 1.71, p = 0.01). Hospitalization rate did not differ. Elderly had more hematological toxicities (56 vs. 32%, p = 0.01) and less frequently received first-line platinum combinations (96 vs. 69%, p < 0.001). Conclusions: Elderly patients had a marginally worse survival compared to young patients. Despite the less frequent use of combination chemotherapy, elderly patients experienced toxicity more often. Survival of those ≥75 years was significantly worse, indicating the urgent need of further research particularly in this age group.
   
citation Früh M, Besrour H, Gillessen S, Joerger M, Hitz F, Savidan A, Cerny T, Ess S. Management of elderly patients with advanced non-small cell lung cancer: a single-center experience. Chemotherapy 2013; 59:42-50.
   
type journal paper/review (English)
date of publishing 02-07-2013
journal title Chemotherapy (59/1)
ISSN electronic 1421-9794
pages 42-50
PubMed 23838903
DOI 10.1159/000350498