Management of elderly patients with advanced non-small cell lung cancer in Turkey

Non-small cell lung cancer is a disease that affects the elderly. However, most patients older than 70 years are less likely to receive standard therapy than their younger counterparts and the aim of the present study was to determine age-dependent variation in efficacy.

Between 2004-2008, 40 consecutive patients older than 70 years received treatment for advanced non-small cell lung cancer. All were evaluated for response and toxicity. Chemotherapy was either with cisplatin or carboplatin and double or single agents (vinorelbine, gemcitabine). Docetaxel was used as a second line therapy in selected cases. Patients were grouped according to age: group 1 (70-74 years), group 2 (>or= 75 years).

Except for 4 cases, all received chemotherapy, and 61 % were given a cisplatin-containing regimen. Second-line therapy was given to 42.5% and grades 3-4 neutropenia was seen in 17 (42.5%). Only one patient died due to neutropenic fever. Nephrotoxicity was observed in 2 (5%) and one underwent hemodialysis. Overall survival was 10 months, with median survival periods for groups 1 and 2 of 13 and 10 months, respectively (p> 0.05). No differences were found regarding type of chemotherapy administered or adverse events between the 2 groups.

Patients older than 75 years appear to deserve the same standard therapy for non-small cell lung cancer as that given to younger cases.