Department of Radiation Oncology, MAASTRO Clinic, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands.
Eur J Cancer. 2011 Dec;47(18):2691-7. doi: 10.1016/j.ejca.2011.06.023. Epub 2011 Jul 4.
There is little data on the survival of elderly patients with stage III non-small cell lung cancer (NSCLC).
Patients with stage III NSCLC in the Netherlands Cancer Registry/Limburg from January 1, 2002 to December 31, 2008 were included.
One thousand and two patients with stage III were diagnosed, of which 237 were 75 years or older. From 228 patients, co-morbidity scores were available. Only 33/237 patients (14.5%) had no co-morbidities, 195 (85.5%) had one or more important co-morbidities, 60 (26.3%) two or more co-morbidities, 18 (7.9%) three or more co-morbidities and 2 patients (0.9%) suffered from four co-morbidities. Forty-eight percent were treated with curative intent. No significant difference in Charlson co-morbidity, age or gender was found between patients receiving curative or palliative intent treatment. Treatment with curative intent was associated with increased overall survival (OS) compared to palliative treatment: median OS 14.2 months (9.6-18.7) versus 5.2 months (4.3-6.0), 2-year OS 35.5% versus 12.1%, for curative versus palliative treatment.
Patients who received only radiotherapy with curative intent had a median OS of 11.1 months (95% confidence interval [95% CI] 6.4-15.8) and a 5-year OS of 20.3%; for sequential chemotherapy and radiotherapy, the median OS was 18.0 months (95% CI 12.2-23.7), with a 5-year OS of 14.9%. Only four patients received concurrent chemo-radiation.
In this prospective series treating elderly patients with stage III NSCLC with curative intent was associated with significant 5-year survival rates.
关于 III 期非小细胞肺癌（NSCLC）老年患者的生存数据较少。
纳入 2002 年 1 月 1 日至 2008 年 12 月 31 日期间荷兰癌症登记处/林堡的 III 期 NSCLC 患者。
诊断出 102 例 III 期患者，其中 237 例患者年龄在 75 岁或以上。从 228 例患者中，获得了合并症评分。仅有 33/237 例患者（14.5%）没有合并症，195 例（85.5%）有 1 种或多种重要合并症，60 例（26.3%）有 2 种或更多合并症，18 例（7.9%）有 3 种或更多合并症，2 例（0.9%）患有 4 种合并症。48%的患者接受了根治性治疗。接受根治性或姑息性治疗的患者在合并症 Charlson 评分、年龄或性别方面无显著差异。与姑息性治疗相比，接受根治性治疗与总生存（OS）增加相关：中位 OS 为 14.2 个月（9.6-18.7）与 5.2 个月（4.3-6.0），2 年 OS 为 35.5%与 12.1%，用于根治性与姑息性治疗。
仅接受根治性放疗的患者中位 OS 为 11.1 个月（95%置信区间[95%CI]6.4-15.8）和 5 年 OS 为 20.3%；序贯化疗和放疗的中位 OS 为 18.0 个月（95%CI12.2-23.7），5 年 OS 为 14.9%。仅 4 例患者接受了同期放化疗。
在这项前瞻性系列研究中，对 III 期 NSCLC 老年患者进行根治性治疗与显著的 5 年生存率相关。
