Li Feiyang, Li Fang, Lu Haowei, Zhao Dong
Department of Medical Oncology, Lixin People's Hospital of Bozhou City, Ward 2, Bozhou City, Anhui Province, China.
Department of Medical Oncology, Affiliated Hospital of Qinghai University, Ward 1, Xining City, Qinghai Province, China.
BMC Cancer. 2025 Jul 30;25(1):1244. doi: 10.1186/s12885-025-14687-8.
This study investigates survival differences between elderly and younger patients with advanced non-small cell lung cancer and their relationship with multimodal treatments, aiming to inform clinical decision-making.
We retrospectively analyzed clinical data from 590 patients diagnosed with advanced non-small cell lung cancer between 2018 and 2024. Data included demographics, tumor characteristics, and survival outcomes. Propensity score matching was used to balance baseline characteristics, and Kaplan-Meier curves and multivariate Cox regression models assessed survival differences.
After propensity score matching, no significant baseline differences were observed. Kaplan-Meier analysis showed median overall survival of 21 months for the ≥ 70 years group and 19 months for the < 70 years group (HR = 0.941, 95% CI 0.766-1.156, P = 0.555). Median cancer-specific survival was 21 months for the ≥ 70 years group and 17 months for the < 70 years group (HR = 0.892, 95% CI 0.716-1.112, P = 0.298). Cox regression analyses revealed that age was not an independent prognostic factor for survival. Subgroup analysis indicated potential heterogeneity in the lung metastasis subgroup (P = 0.047), but no significant interaction effects were found in other subgroups.
Elderly patients with advanced non-small cell lung cancer achieve comparable survival benefits to younger patients when treated with multimodal approaches. Age is not an independent prognostic factor. These findings support multimodal treatment strategies for elderly patients and highlight the need for further research into personalized treatment plans.
本研究调查老年和年轻晚期非小细胞肺癌患者的生存差异及其与多模式治疗的关系，旨在为临床决策提供依据。
我们回顾性分析了2018年至2024年间590例诊断为晚期非小细胞肺癌患者的临床数据。数据包括人口统计学、肿瘤特征和生存结果。采用倾向评分匹配来平衡基线特征，并使用Kaplan-Meier曲线和多变量Cox回归模型评估生存差异。
倾向评分匹配后，未观察到显著的基线差异。Kaplan-Meier分析显示，≥70岁组的中位总生存期为21个月，<70岁组为19个月（HR = 0.941，95%CI 0.766-1.156，P = 0.555）。≥70岁组的中位癌症特异性生存期为21个月，<70岁组为17个月（HR = 0.892，95%CI 0.716-1.112，P = 0.298）。Cox回归分析显示，年龄不是生存的独立预后因素。亚组分析表明肺转移亚组存在潜在异质性（P = 0.047），但在其他亚组中未发现显著的交互作用。
老年晚期非小细胞肺癌患者采用多模式治疗时，其生存获益与年轻患者相当。年龄不是独立的预后因素。这些发现支持老年患者的多模式治疗策略，并强调需要进一步研究个性化治疗方案。
