Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumicho, Suntogun, Shizuoka 411-8777, Japan.
Lung Cancer. 2011 Feb;71(2):173-7. doi: 10.1016/j.lungcan.2010.05.014. Epub 2010 Jun 8.
Because of the number of elderly patients with NSCLC is increasing, it is becoming a public health problem world wide. In elderly patients with advanced NSCLC, mono-chemotherapy is the standard treatments. But little information is available for patients aged ≥80 regarding the management of advanced NSCLC.
The purpose of the present study is to evaluate the efficacy and safety of chemotherapy for patients aged ≥80.
110 patients aged ≥75 with advanced NSCLC were retrospectively reviewed. Data was collected from the electronic medical records of our hospital from January 2005 to August 2008. The patient population was divided into three age groups: patients aged ≥80 who received chemotherapy (group A), patients aged 75-79 who received chemotherapy (group B), and patients aged ≥75 who received only best supportive care (group C). Date cut-off of this study was on 20th June, 2009. We evaluated and compared the survival and the toxicity between three groups.
Among 110 patients, there were 21 patients in group A, 55 patients in group B, 34 patients in group C. Among group C, there were 8 patients aged 75-79 and the main reasons for BSC were poor PS in 7 patients, and there were 26 patients aged ≥80 and the main reason for BSC were age itself in 17 patients. Response rate and disease control rate were similar in group A and group B (16.4% vs. 23.8%, and 57.1% vs. 49.1%). MST was 237 days in group A with PS 0-2 and was 232 days in group C with PS 0-2. Median PFS and MST were 86 and 237 days in group A with PS 0-2 and was 107 and 263 days in group B. Toxicity profile of group A seems to be acceptable: over grade 3 leucopenia was observed 33%; over grade 3 neutropenia was 52%; but no febrile neutropenia; over grade 3 non-hemotological toxicity was observed 14%.
There was no obvious difference between patients aged ≥80 and 75-79 in terms of safety and efficacy of chemotherapy. Patients aged ≥80 with advanced NSCLC who have good PS might be good candidates for the chemotherapy.
由于患有非小细胞肺癌的老年患者数量不断增加，这已成为一个全球性的公共卫生问题。对于晚期非小细胞肺癌的老年患者，单药化疗是标准治疗。但对于年龄≥80 岁的患者，有关晚期非小细胞肺癌的管理信息很少。
本研究旨在评估≥80 岁患者化疗的疗效和安全性。
回顾性分析 2005 年 1 月至 2008 年 8 月我院电子病历中 110 例年龄≥75 岁的晚期非小细胞肺癌患者。将患者分为三组：接受化疗的年龄≥80 岁患者（A 组）、接受化疗的年龄 75-79 岁患者（B 组）和仅接受最佳支持治疗的年龄≥75 岁患者（C 组）。本研究数据截止日期为 2009 年 6 月 20 日。我们评估并比较了三组患者的生存情况和毒性反应。
110 例患者中，A 组 21 例，B 组 55 例，C 组 34 例。C 组中，年龄 75-79 岁的患者有 8 例，主要原因是 7 例患者 PS 较差，年龄≥80 岁的患者有 26 例，主要原因是 17 例患者年龄本身。A 组和 B 组的缓解率和疾病控制率相似（16.4%比 23.8%，57.1%比 49.1%）。A 组 PS 0-2 患者的中位总生存期（MST）为 237 天，C 组 PS 0-2 患者的 MST 为 232 天。A 组 PS 0-2 患者的中位无进展生存期（PFS）和 MST 分别为 86 和 237 天，B 组分别为 107 和 263 天。A 组的毒性谱似乎可以接受：33%观察到 3 级以上白细胞减少症；52%观察到 3 级以上中性粒细胞减少症；但无发热性中性粒细胞减少症；14%观察到 3 级以上非血液学毒性。
在安全性和疗效方面，年龄≥80 岁和 75-79 岁的患者之间没有明显差异。PS 良好的年龄≥80 岁的晚期非小细胞肺癌患者可能是化疗的合适候选者。
