Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Internal Medicine and Environmental Health Center, Kangwon National University Hospital, Chuncheon, Korea.
Cancer Res Treat. 2021 Jan;53(1):104-111. doi: 10.4143/crt.2020.894. Epub 2020 Oct 5.
As the aging of society progresses, the proportion of extremely older lung cancer patients has also increased; However, studies of these patients with non-small cell lung cancer are limited. Therefore, we investigated the initial treatment modalities and survival outcomes for patients aged 80 years or over.
We included a multicenter retrospective cohort from the Korean Association for Lung Cancer Registry, which surveys 10% of the newly diagnosed lung cancer patients across 52 hospitals in Korea. We analyzed and compared the 2014-2016 data of the non-small cell lung cancer patients aged ≥ 80 years and those aged < 80 years.
Of the 6,576 patients reviewed, 780 patients were aged ≥ 80 years, and 5,796 patients were aged < 80 years. In the patients aged ≥ 80 years, surgery and radiation therapy resulted in longer patient survival among those with a resectable tumor (stage I-II) than the best supportive care (median survival, not reached [surgery] vs. 32.2 months [radiation therapy] vs. 11.43 months [best supportive care]). The duration of survival in patients with advanced-stage (IV) lung cancers was higher after chemotherapy than after the best supportive care (median survival, 8.63 months vs. 2.5 months). Patients with stage IV adenocarcinoma who received targeted therapy had better survival than those who did not (median survival, 9.0 months vs. 4.3 months).
Even in extremely older patients, active treatments, such as surgery, radiation therapy, and chemotherapy, can result in better survival outcomes than the best supportive care.
随着社会老龄化的进展，极高龄肺癌患者的比例也有所增加；然而，针对这些非小细胞肺癌患者的研究有限。因此，我们调查了 80 岁及以上患者的初始治疗方式和生存结局。
我们纳入了韩国肺癌登记协会的一项多中心回顾性队列研究，该研究对韩国 52 家医院的 10%新诊断肺癌患者进行调查。我们分析并比较了 2014-2016 年年龄≥80 岁和<80 岁的非小细胞肺癌患者的数据。
在 6576 例患者中，有 780 例年龄≥80 岁，5796 例年龄<80 岁。在年龄≥80 岁的患者中，与最佳支持治疗相比，手术和放疗可使可切除肿瘤（I 期-II 期）患者的生存时间更长（中位生存时间，未达到[手术] vs. 32.2 个月[放疗] vs. 11.43 个月[最佳支持治疗]）。与最佳支持治疗相比，化疗可使晚期（IV 期）肺癌患者的生存时间更长（中位生存时间，8.63 个月 vs. 2.5 个月）。接受靶向治疗的 IV 期腺癌患者的生存时间优于未接受靶向治疗的患者（中位生存时间，9.0 个月 vs. 4.3 个月）。
即使是极高龄患者，积极的治疗方法，如手术、放疗和化疗，也可以比最佳支持治疗带来更好的生存结局。
