老年和极老年非小细胞肺癌患者的特征与管理。

Characterization and management of elderly and very elderly patients with non-small cell lung cancer.

机构信息

Pulmonology Unit - Thorax Department, North Lisbon Hospital Center, Lisbon, Portugal.

Pulmonology Oncology Unit - Thorax Department, North Lisbon Hospital Center, Lisbon, Portugal.

出版信息

Clin Respir J. 2020 Jul;14(7):683-686. doi: 10.1111/crj.13184. Epub 2020 Mar 26.

DOI:10.1111/crj.13184

PMID:32170824

Abstract

OBJECTIVES

Despite non-small cell lung cancer (NSCLC) high prevalence and increasing incidence, evidence specific to the elderly and very elderly is sparse. To retrospectively compare characterization and approach of NSCLC patients (pts) aged 70-79 and ≥80 years.

METHODS

We performed a retrospective analysis of 297 adult NSCLC pts who registered and initiated NSCLC management in our Pulmonology Oncology Unit from January 2013 to December 2016 corresponding to 38.2% of all NSCLC patients (n = 778). Demographic data and lung cancer management were analysed.

RESULTS

Pts were categorized as elderly (n = 211, 71.0%) and very elderly (n = 86, 29.0%). Very elderly pts had worse Eastern Cooperative Oncology Group performance status (P = 0.047), higher Charlson age comorbidity index (P < 0.001) and the majority had stage IV cancer (66.3%, P = 0.04). The first management option in very elderly pts was chemotherapy (CTX) (30.2%, P = 0.37) and in elderly pts was multimodal therapy (30.3%, P ≤ 0.001). Support therapy and first-line targeted (EGFR or ALK-positive) were more common in the very elderly (23.6%, P = 0.01; 17.4% P = 0.002, respectively). Curative radiation or surgery rates did not differ between groups. Reasons for premature first-line CTX stop, toxicity and hospitalization did not differ. Death rate (69.7% vs 63.5% for very elderly and elderly, respectively) and mean survival since diagnosis (11.5 vs 11.6 months for very elderly and elderly, respectively) did not differ.

CONCLUSIONS

There were significant differences in pts characteristics having the very elderly more multimorbidity and advanced state of disease. First management options were significantly different with respect to multimodal, targeted and support therapy.

摘要

目的

尽管非小细胞肺癌（NSCLC）的发病率很高，但针对老年人和非常老年人的证据却很少。本研究旨在回顾性比较 70-79 岁和≥80 岁 NSCLC 患者的特征和治疗方法。

方法

我们对 2013 年 1 月至 2016 年 12 月期间在我们的呼吸肿瘤内科登记并开始 NSCLC 治疗的 297 名成年 NSCLC 患者进行了回顾性分析，这些患者占所有 NSCLC 患者（n=778）的 38.2%。分析了患者的人口统计学数据和肺癌管理情况。

结果

患者分为老年组（n=211，71.0%）和非常老年组（n=86，29.0%）。非常老年组患者的东部合作肿瘤组表现状态（ECOG PS）较差（P=0.047），Charlson 合并症年龄指数较高（P<0.001），且多数为 IV 期癌症（66.3%，P=0.04）。非常老年组患者的第一治疗选择是化疗（CTX）（30.2%，P=0.37），老年组患者的第一治疗选择是多模式治疗（30.3%，P≤0.001）。支持治疗和一线靶向（EGFR 或 ALK 阳性）在非常老年组中更为常见（23.6%，P=0.01；17.4%，P=0.002）。两组之间的根治性放疗或手术率没有差异。一线 CTX 停药、毒性和住院的原因没有差异。死亡率（非常老年组为 69.7%，老年组为 63.5%）和诊断后平均生存时间（非常老年组为 11.5 个月，老年组为 11.6 个月）没有差异。