PURPOSE: The current standard first-line treatment for elderly patients with NSCLC is single agent chemotherapy. But the prognosis is poor. The median overall survival is only 6.5 month and 1-year survival is about 32%. Elderly patients have been habitually underrepresented in clinical trials due to toxicity concerning. The aim of the study was to evaluate the efficacy and toxicity of platinum-based chemotherapy for elderly patients with advanced NSCLC.
METHODS: Retrospectively analyzed the data of 41 elder patients aged over 70 with advanced NSCLC, who were treated with platinum-based chemotherapy from October 2002 to December 2005.
RESULTS: Of the 41 patients, the medium age was 73, 28 patients were male. Adenocarcinoma was 73.2%. 75.6% patients were stage IV. All patients had adequate born marrow, heart, hepatic and renal function. The PS of all patients was 0 or 1. All patients received at least one cycle of platinum- based chemotherapy(cisplatin 60mg/m2 or carboplatin AUC4 or 5 d1 plus novelbine 25mg/m2 d1 and d8 or gemcitabine 1000mg/m2d1 and d8 or paclitaxel 130mg/m2d d1 and d8 or docetaxel 40mg/m2d1 and d8, repeated every 21 days for 4 cycles or until disease progress or intolerable toxicity). 18 patients treated with vinorelbine regimen, 9 patients with gemcitabine regimen, 7 patients with paclitaxel and docetaxel regimen each. The overall response rate was 19.5%. The median time to progression and median survival times were 5.8 months and 14.2 months separately. 1-year survival rate was 65.8%. The major side effect was myelosuppression (53.7%), among which grade 3 and 4 was 26.9%. Gastro-intestinal side effect was 14.6%, and most were grade 1 or 2. There was no statistical difference among the four regimens. Three patients withdraw chemotherapy after one cycle due to side effects. 2 were from vinorelbine group and 1 was from gemcitabine group. There was no treatment-related death.
CONCLUSION: The platinum-based chemotherapy was effective and well-tolerated for fit elder patients with advanced NSCLC.
CLINICAL IMPLICATIONS: The platinum-based chemotherapy could be used as first-line treatment for elderly patient with NSCLC.
DISCLOSURE: Xiaotong Zhang, No Financial Disclosure Information; No Product/Research Disclosure Information