[How should we treat elderly patients with small cell lung cancer?--information gathered by questionnaires and analysis of 351 patients aged 70 or over. West Japan Thoracic Oncology Group].

The incidence of elderly patients with small cell lung cancer is increasing in Japan. Because of the variation in their physical function and increasing co-morbid disease, elderly patients are usually excluded from clinical trials. Questionnaires were sent to 40 institutes of the "West Japan Thoracic Oncology Group", and answers from 33 (83%) institutes were obtained. Eighty-five percent of replies recognized the need of trials for limited disease (LD) and 70% for extensive disease (ED). We investigated the methods of staging procedures, and management of 351 small cell lung cancer patients aged 70 years or older diagnosed from 1994 to 1996 in 28 institutes. There were 173 patients aged 70-74, 120 aged 75-80, and 58 aged 80 years or older. Staging procedures including chest CT, abdominal CT, abdominal CT or Echo. Brain CT or MRI and bone scinti scan were performed in 333 (95%) patients. One hundred fifty-nine of 178 patients with LD and 143 of 168 patients with ED received anticancer therapy. Although 48% of PS 0-1 patients received 4 courses or more of chemotherapy, among the patients with ED 24% of patients with PS 2 and 19% of PS 3 patients received adequate chemotherapy. The response rate was 79% for LD and 69% for ED. Many elderly patients received insufficient courses and/or doses of chemotherapy but achieved a good response. Median survival for patients with LD and ED was 12 and 6 months, respectively. To determine suitable regimens for elderly patients with lung cancer, more clinical trials are definitely needed.