PURPOSE: Sixty percent of all neoplasms and two-thirds of all deaths due to cancer occur in persons older than 65 years. More than 50% of patients with lung cancer are older than 65 years and 30% older than 70 years. With more persons surviving to older age treatment of the elderly with lung cancer has become an important issue.
METHODS: All patients 75 years or older with lung cancer seen at the Department of Respiratory Medicine and Allergy, Karolinska Hospital from 2003 to 2006 were retrospective reviewed. In all, 438 patients were analyzed.
RESULTS: The mean age was 80 years, 250 (57.1%) were men. 94.8% of the males and 81.4% of the females were smokers or former smokers. 328 (74.9%) had PS 0-2. 7.5% had SCLC, 37% adenocarcinoma, and 21.2% squamous cell carcinoma. 19,2% had clinical lung cancer and the others broncheoalveolar cell carcinoma or low differentiated carcinoma. 10,1% underwent radical surgery, 24% received chemotherapy only, 20,8% radiotherapy against the tumour (thereof stereotactic 5,9%), and 1,8% concomitant chemo-radiotherapy. 6,6% received radiotherapy against metastases, and 36.6% had no therapy. Only 7,1% were given second-line chemotherapy. Survival was 163 and 159 days for patients 75-80 years and >80 years, respectively. Patients with PS=0 survived 236 days, those with PS=3 only 27 days. Survival among smoker or former smokers and never smokers were 212 and 132 days, respectively. Survival among those who received chemotherapy was 573 days, while for the others it was 181 days.
CONCLUSIONS: Significant survival among patients given second line chemotherapy (p<0.036). Significant survival among patients between 75-80 versus > 80 years old (P<0.032).
CLINICAL IMPLICATIONS: Treatment of elderly patients with lung cancer is feasible if they have a good PS and seems to result in prolonged survival.
DISCLOSURE: The following authors have nothing to disclose: Hirsh Koyi, Eva Brandén, Gunnar Hillerdal
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