Do elderly patients with non-small cell lung cancer get the best out of recent advances in first-line treatment? A comparative study in two tertiary cancer centers in Greece. Issue 2 (March 2015)

• Record Type: Journal Article
• Authors: Bakogeorgos, Marios; Mountzios, Giannis; Bournakis, Evangelos; Economopoulou, Panagiota; Kotsantis, Giannis; Fytrakis, Nikolaos; Kouvatseas, Georgios; Dimopoulos, Meletios-Athanassios; Kentepozidis, Nikolaos
• Is Part Of: Journal of geriatric oncology. Volume 6:Issue 2(2015)
• Page Start: 111
• Page End: 118
• Publication Date: 2015-03
• Subjects: Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2014.11.001
• Languages: English
• ISSNs: 1879-4068

Abstract

<abstract abstract-type="author" id="ab0005"> <title id="st0005">Abstract</title> <sec> <title id="st0010">Background</title> <p id="sp0005">Elderly patients with advanced non-small cell lung cancer (NSCLC) are thought to receive suboptimal treatment mainly due to concerns for poor compliance and/or excessive toxicity.</p> </sec> <sec> <title id="st0050">Patients and Methods</title> <p id="sp0015">Using the age of 70 years as the pre-defined cut-off, we compared elderly patients with advanced NSCLC suitable for first line chemotherapy with their younger counterparts in terms of: i) diagnosis and disease characteristics ii) adherence to treatment schedule, including dose intensity (DI), and relative dose intensity (RDI), iii) toxicity, tolerance, and efficacy outcomes.</p> </sec> <sec> <title id="st0015">Results</title> <p id="sp0020">Among 292 eligible patients, data were available for 245, of whom 107 (43.7%) belonged to the elderly group. This group was more likely to present with co-morbidities, non-smoking current status and diagnosis based on cytology alone. As compared to the non-elderly, elderly patients were more likely to receive single-agent therapy (8.0% vs. 29.2% respectively, <italic>p</italic> < 0.001) and less likely to receive platinum-based chemotherapy (80.3% vs. 57.9%, <italic>p</italic> < 0.001). Elderly patients also received docetaxel (24.3% vs. 40.4%), and bevacizumab (7.5% vs. 21.3%) significantly less often and received oral vinorelbine (24.3% vs. 11.8%) more frequently. Non-elderly patients were more likely to receive any of the cytotoxic drugs with RDI > 0.8 (49.6% vs. 33.0%, <italic>p</italic> = 0.012) and RDI > 0.9 (29.6% vs. 16%, <italic>p</italic> = 0.015). Substantial toxicity, as well as median overall survival did not differ significantly between the two groups.</p> </sec> <sec> <title id="st0020">Conclusions</title> <p id="sp0025">Only one third of the elderly patients received at least 80% of the scheduled treatment intensity. Nearly half received diagnosis based on cytology alone, which may deprive them from new, histology-driven, therapeutic approaches.</p> </sec> </abstract>