Abstract
Background: This retrospective study was to evaluate the efficacy and toxicity of gemcitabine plus carboplatin (GC regimen) and paclitaxel plus carboplatin (PC regimen) combination chemotherapy in elderly patients with non-small cell lung cancer. Methods: Seventy-four patients (GC regimen, n = 44; PC regimen, n= 30) received gemcitabine at a dose of 1000 mg/m2 on days 1 and 8, and carboplatin with the target dose of area under the curve (AUC) of 4 on day 8 every 28 days and paclitaxel at a dose of 70 mg/m2 on days 1, 8 and 15, and carboplatin with the target dose of AUC of 5 on day 1 every 28 days. Patients were divided in two groups (younger one: n = 42, old; elderly one: n= 32, ≥70 years old). Results: A total of 222 cycles of the treatment wasadministered. Seventy-one patients (95.9%) completed the scheduled cycles. Two patients in the elderly group were discontinued (6.3%) due to hematological toxicity and melena in the GC regimen and to grade 4 pneumonia in the PC regimen. The dose was reduced in 8 patients (10.8%) due to grade 4 thrombocytopenia. Grade 3/4 neutropenia was not significantly observed in both groups (younger group: 24/42, 57.1%; elderly group: 19/32, 59.4%, p = 0.8471). The nonhematological toxicities were mild in both groups. However, in theelderly group, grade 3/4 thrombocytopenia was significantly observed in the GC group (GC: 5/17, 29.4%; PC: 0/15, 0.0%, p = 0.0222). There was no treatment-related death. Conclusion: These results demonstrate that the GC and PC combination chemotherapies are efficacious and feasible regimens for lung cancer therapy, especially, both regimens should be considered as one of the standard therapies for elderly patients during lung cancer therapy.
Highlights
The incidence of lung cancer, the leading cause of cancer deaths, increases with age
The main reasons given for withholding standard platinum-based doublet regimens from elderly patients are the age-related impairment of organ functions, presence of potentially complicating comorbid conditions, and a lower ability to tolerate the potential toxicity of the combination chemotherapy than younger patients
Since the end of World War II, there has been a dramatic expansion in the world’s population; in addition to the post-war generation of baby boomers, advances in health and healthcare delivery have led to an increased life expectancy
Summary
The incidence of lung cancer, the leading cause of cancer deaths, increases with age. The main reasons given for withholding standard platinum-based doublet regimens from elderly patients are the age-related impairment of organ functions, presence of potentially complicating comorbid conditions, and a lower ability to tolerate the potential toxicity of the combination chemotherapy than younger patients. This retrospective study was to evaluate the efficacy and toxicity of gemcitabine plus carboplatin (GC regimen) and paclitaxel plus carboplatin (PC regimen) combination chemotherapy in elderly patients with non-small cell lung cancer. Conclusion: These results demonstrate that the GC and PC combination chemotherapies are efficacious and feasible regimens for lung cancer therapy, especially, both regimens should be considered as one of the standard therapies for elderly patients during lung cancer therapy
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