45P SMALL CELL LUNG CANCER (SCLC) IN ELDERLY PATIENTS (PTS)

Abstract

Background: The incidence of lung cancer and the proportion of the population over age 65 are increasing. We undertook a retrospective review of routinely treated pts with SCLC in attempt to assess the effect of age on treatment decisions and survival. Patients and Methods: Our retrospective analysis included 269 pts who were treated with standard first-line therapy (concomitant chemo-radiotherapy or chemotherapy (Cht)) at University Clinic Golnik and Institute of Oncology Ljubljana, between 2001 and 2008. We collected data on pts, tumour and treatment characteristics and analysed them according to the pts age (younger than 70 years (y) or 70 y and older). The survival analysis was performed using the Kaplan Meier method. Results: Median age of our pts was 66 y (range 41 to 89). There were 170 pts (63%) younger than 70 y, among them 70 pts had limited disease (LD), 100 pts extended disease (ED). Ninety-nine pts (37%) were 70 y or older, among them 39 pts had LD, 60 pts ED. No significant (sign.) differences existed between the age groups with respect to sex, stage, weight loss, LDH, CRP, anaemia, thrombocytosis, location, and number of metastatic sites. However, sign. differences in terms of higher co-morbidity index, less smoking and less second line Cht in older pts were observed. No sign. difference in mPFS after first line Cht for younger pts compared to older pts was observed, neither in the whole population (7.4 vs 6.9 mos, P= 0.173), neither in the subpopulation of pts with LD (11.1 vs 10.7 mos, P= 0.154) nor in pts with ED (6.3 vs 5.8 mos, P= 0.615). However, mOS was sign. shorter for older pts (11.5 vs 9.2 mos, P= 0.002), with sign. differences observed in both LD (16.4 vs 13.3 mos, P= 0.011) and ED (9.7 vs 7.2 mos, P= 0.029). In the univariate analysis age, LDH, co-morbidity index and second line Cht were found to be sign. prognostic factors for OS, while in the multivariate analysis only age and LDH retained their prognostic value. Conclusion: In our analysis, mPFS from first line therapy was not different according to age more or less than 70 y; however, mOS was sign. shorter in older pts, most likely as an effect of second line Cht withdrawal. Cht should not be withheld from older SCLC pts on the basis of the age alone. Disclosure: All authors have declared no conflicts of interest.