Berghmans T, Tragas G, Sculier J P
Department of Internal Medicine, Institut Jules Bordet, Rue Héger-Bordet, 1, 1000 Brussels, Belgium.
Support Care Cancer. 2002 Nov;10(8):619-23. doi: 10.1007/s00520-002-0396-6. Epub 2002 Sep 4.
The present study was conducted to determine whether it is justifiable to adapt treatment to age in patients with non-small-cell lung cancer (NSCLC). All NSCLC patients treated at the Institut Jules Bordet who were 75 years old or over were prospectively entered in our database. Patients were divided into those who were "eligible" and those who were "ineligible" for clinical trials according to the standard criteria used by the ELCWP. The 604 consecutive patients treated for NSCLC between March 1995 and August 2001 included 60 (9.9%) aged 75 years or over. Their principal characteristics were as follows: median age 78 years (75-93); male-to-female ratio 45/15; stages I/II/III/IV in 16/1/23/18 cases (in 2 cases complete work-up was refused by the patient); squamous/glandular/other histology in 23/24/13 cases; the median performance status was 70 (30-100). Except for their age, 37 patients met the eligibility criteria for the ELCWP standard treatment study protocol in progress during the study period. Twenty-five (67.6%) of these patients received an adequate treatment according to the stage of the disease, and 5 (13.5%) refused conventional therapy and received less aggressive treatment or none at all. For 7 (18.9%) patients, an adapted treatment was chosen solely on the basis of their age. For patients with disease in stages I-III who underwent adequate treatment survival rates were equivalent to the results found in the literature, with median survival times of 770 days and 262 days for those with stage I-II and those with stage III disease, respectively. Survival rates for patients with stage IV disease ranged from 10 days to 17 months. NSCLC patients 75 years of age or more without significant co-morbidities can probably be treated in the same way as younger people with similar survival rates if their disease is in stages I-III. Because the number of patients was too small, our data do not allow us to provide meaningful conclusions for stage IV disease.
本研究旨在确定非小细胞肺癌（NSCLC）患者根据年龄调整治疗方案是否合理。所有在朱尔斯·博尔德研究所接受治疗的75岁及以上的NSCLC患者均被前瞻性纳入我们的数据库。根据欧洲肺癌工作组（ELCWP）使用的标准标准，患者被分为符合临床试验“资格”和不符合“资格”两类。1995年3月至2001年8月期间连续治疗的604例NSCLC患者中，有60例（9.9%）年龄在75岁及以上。他们的主要特征如下：年龄中位数78岁（75 - 93岁）；男女比例为45/15；I/II/III/IV期分别为16/1/23/18例（2例患者拒绝进行全面检查）；鳞状/腺状/其他组织学类型分别为23/24/13例；中位体能状态为70（30 - 100）。除年龄外，37例患者符合研究期间正在进行的ELCWP标准治疗研究方案的资格标准。其中25例（67.6%）患者根据疾病分期接受了适当治疗，5例（13.5%）拒绝传统治疗，接受了不太积极的治疗或根本未接受治疗。7例（18.9%）患者仅根据年龄选择了调整后的治疗方案。对于接受了适当治疗的I - III期疾病患者，生存率与文献报道结果相当，I - II期和III期疾病患者的中位生存时间分别为770天和262天。IV期疾病患者的生存率为10天至17个月。75岁及以上且无严重合并症的NSCLC患者，如果疾病处于I - III期，可能可以与年轻患者以相同方式治疗，生存率相似。由于患者数量过少，我们的数据无法为IV期疾病提供有意义的结论。
