Quoix E, Monnet I, Scheid P, Hamadouche A, Chouaid C, Massard G, Depierre A, Souquet P-J, Braun D, Girard P, Breton J-L, Lebitasy M-P, Milleron B
Service de pneumologie, nouvel hôpital civil, hôpitaux universitaires, université de Strasbourg, 1, place de l'hôpital, 67091 Strasbourg cedex, France.
Rev Mal Respir. 2010 May;27(5):421-30. doi: 10.1016/j.rmr.2010.02.013. Epub 2010 Mar 25.
Lung cancer in the elderly is considerably increasing in frequency, representing a public health issue. Those patients are underrepresented in clinical trials and probably not optimally treated.
We performed a survey of the management and the outcome of lung cancer patients aged 70 and more in France between August 2002 and September 2003 according to age categories (70-74, 75-79 and > or =80 years). One thousand six hundred and twenty-seven patients were analysed for descriptive data and 1595 for survival.
Median age was 75 (70-96) and male:female ratio was 4.26 with a decrease across the age categories from 5.1 to 3.0. Tobacco-linked comorbidities were frequent. The median value of Charlson's index was 2. About 58% had a performance status (PS) 0 or 1, 30% a PS 2 and 12% a PS>2. The proportion of never-smokers (11.6%) increased significantly with age categories. Regarding imaging procedures, as much as 83.3% of the patients had at least a chest CT-scan and a brain CT-scan (or MRI) and an abdominal ultrasound or CT-scan. Best Supportive Care (BSC) as only treatment was administered to 16.1% of the patients. Among patients specifically treated, 22.9% were operated, 21.8% received mediastinal irradiation and 71.5% chemotherapy. Overall, median survival time was 9.14 months with 23.5% deaths occurring before 3 months. Low category of age, good PS, non-smoking and high body mass index (BMI) were favorable independent prognostic factors of survival. Age, PS and tobacco smoking were prognostic of early death.
A large majority of elderly lung cancer patients in France are managed like younger counterparts regarding diagnostic procedures and treatment. Age remains an independent prognostic factor as well for overall survival as for early death.
老年肺癌的发病率在显著上升，这已成为一个公共卫生问题。这些患者在临床试验中的代表性不足，可能未得到最佳治疗。
我们对2002年8月至2003年9月期间法国70岁及以上肺癌患者的管理和结局按年龄类别（70 - 74岁、75 - 79岁和≥80岁）进行了一项调查。对1627例患者分析了描述性数据，对1595例患者分析了生存情况。
中位年龄为75岁（70 - 96岁），男女比例为4.26，且该比例随年龄类别从5.1降至3.0。与烟草相关的合并症很常见。查尔森指数的中位值为2。约58%的患者体能状态（PS）为0或1，30%为PS 2，12%为PS>2。从不吸烟者的比例（11.6%）随年龄类别显著增加。关于影像学检查，多达83.3%的患者至少进行了胸部CT扫描、脑部CT扫描（或MRI）以及腹部超声或CT扫描。仅接受最佳支持治疗（BSC）的患者占16.1%。在接受特异性治疗的患者中，22.9%接受了手术，21.8%接受了纵隔照射，71.5%接受了化疗。总体而言，中位生存时间为9.14个月，23.5%的患者在3个月前死亡。年龄较低、PS良好、不吸烟和高体重指数（BMI）是生存的有利独立预后因素。年龄、PS和吸烟是早期死亡的预后因素。
在法国，绝大多数老年肺癌患者在诊断程序和治疗方面与年轻患者的处理方式相同。年龄仍然是总体生存以及早期死亡的独立预后因素。
