Cardia Joana, Calçada Cármen, Pereira Helena
Radiation Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, EPE (Portuguese Institute of Oncology - Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.
Rep Pract Oncol Radiother. 2011 Feb 23;16(2):45-8. doi: 10.1016/j.rpor.2011.01.001. eCollection 2011.
More than 50% of new cases of lung cancer (LC) are diagnosed in elderly patients. It is necessary to know correct treatment of these patients but there is a lack of evidence-based data regarding this age group, leading to an undertreatment based on a supposed lack of tolerance to radical treatments.
To evaluate the results of radiotherapy (RT) treatment in elderly patients with LC in our institution and the relation between survival, toxicity and comorbidities.
We retrospectively analyzed all patients over 70 years old with LC, treated with RT with or without chemotherapy (CT), in the radiotherapy department of the Instituto Português de Oncologia do Porto Francisco Gentil (IPOPFG), between January 2000 and December 2007.
Three-year overall survival (OS) rate was 33.8%. Median progression free survival was 18.1 months. For patients treated with exclusive radical radiotherapy the 3-year OS rate was 51.5% and for patients treated with sequential and concurrent CTRT, 3-year survival rates were 44% and 25.4%, respectively. We did not find a statistical relationship between the presence of comorbidities and survival. Toxicity presented by the patients was not influenced by comorbidities and did not influence survival.
Our results allow us to conclude that elderly patients are likely to benefit from radical treatments. Chemo-radiotherapy seems to increase survival but should be used carefully in old patients outside clinical trials. Comorbidities did not seem to influence survival and toxicity of treatments, although larger studies are necessary to prove this.
超过50%的肺癌新发病例在老年患者中被诊断出来。有必要了解这些患者的正确治疗方法，但缺乏关于这个年龄组的循证数据，导致基于对根治性治疗耐受性假设不足而出现治疗不足的情况。
评估我们机构中老年肺癌患者的放射治疗（RT）结果以及生存、毒性和合并症之间的关系。
我们回顾性分析了2000年1月至2007年12月期间在波尔图弗朗西斯科·根蒂尔葡萄牙肿瘤研究所（IPOPFG）放疗科接受RT治疗（有或无化疗（CT））的所有70岁以上的肺癌患者。
三年总生存率（OS）为33.8%。无进展生存期的中位数为18.1个月。对于仅接受根治性放疗的患者，三年OS率为51.5%，对于接受序贯和同步放化疗的患者，三年生存率分别为44%和25.4%。我们未发现合并症的存在与生存之间存在统计学关系。患者出现的毒性不受合并症影响，也不影响生存。
我们的结果使我们能够得出结论，老年患者可能从根治性治疗中获益。放化疗似乎能提高生存率，但在临床试验之外的老年患者中应谨慎使用。合并症似乎不影响治疗的生存和毒性，尽管需要更大规模的研究来证实这一点。
