Chemotherapy in Patients Older than or Equal to 75 Years with Advanced Non-small Cell Lung Cancer
Cancer Research and Treatment 2012³â 44±Ç 1È£ p.37 ~ p.42
±è½ÂÅÂ(Kim Seung-Tae) - Korea University School of Medicine Department of Medicine Division of Hematology-Oncology
¹Ú°æÈ(Park Kyong-Hwa) - Korea University School of Medicine Department of Medicine Division of Hematology-Oncology
¿À»óö(Oh Sang-Cheul) - Korea University School of Medicine Department of Medicine Division of Hematology-Oncology
¼ÀçÈ«(Seo Jae-Hong) - Korea University School of Medicine Department of Medicine Division of Hematology-Oncology
±èÁؼ®(Kim Jun-Suk) - Korea University School of Medicine Department of Medicine Division of Hematology-Oncology
±è¿È«(Kim Yeul-Hong) - Korea University School of Medicine Department of Medicine Division of Hematology-Oncology
½Å»ó¿ø(Shin Sang-Won) - Korea University School of Medicine Department of Medicine Division of Hematology-Oncology
Abstract
Purpose: As the number of elderly patients diagnosed with non-small cell lung carcinoma (NSCLC) increases, the number of these patients receiving chemotherapy also increases. However, limited data exists regarding the use of chemotherapy in advanced NSCLC patients who are 75 years of age or older.
Materials and Methods : Between May 2002 and October 2008, data for 48 advanced NSCLC patients who were 75 years of age or older who had been treated with chemotherapy were retrospectively analyzed.
Results: The median age of study participants at the time of first line chemotherapy was 76 years (range, 75 to 87 years) and their median Charlson comorbidity index was 2 (range, 1 to 4). Of the total 48 patients, 43 patients (90%) were treated by platinum-based doublet as a first line chemotherapy regimen. Median progression free survival for first line chemotherapy was 5.7 months (95% confidence interval [CI], 4.93 to 6.47 months) with an overall response rate of 33.3%. After first line chemotherapy, only 14 of the 48 patients (29.2%) received second line chemotherapy. The median overall survival (OS) for these patients was 8.2 months (95% CI, 4.44 to 11.96 months). Multivariate analysis results indicated that female gender and having received second-line or more chemotherapy were independent prognostic factors for increased OS for all 48 patients. Charlson Index was not a significant independent prognostic factor for survival. There were 9 treatment related deaths due to infectious causes (18.8%).
Conclusion: Patients 75 years of age or older with advanced NSCLC may obtain clinical benefit from the administration of platinum-based doublet or single agent chemotherapy. However, oncologists must consider the aspect of safety in relation to the clinical benefits when managing this patient group.
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Aged, Non-small-cell lung carcinoma, Drug therapy
KMID :
0939920120440010037
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À¯È¿¼º°á°ú(Recomendation)
1) platinum-doublet chemotherapy could be effective for elderly patients with advanced NSCLC; 2) patient selection is important and a strategy should be explored to avoid fetal toxicity in this age group. Patients 75 years of age or older with advanced NSCLC may obtain clinical benefit from the administration of platinum-based doublet or single agent chemotherapy.