Curative Treatment Vs. Best Supportive Care In Advanced Non-Small Cell Lung Cancer In Aged Person

Abstract

Rationale: With the introduction of new chemotherapeutics showing better efficacy and low side effects, it was reevaluated whether the curative anticancer treatment including chemotherapy and/or radiation therapy of curative aim had a survival benefit comparing to best supportive care (BSC) especially in aged advanced lung cancer subjects. Methods: The data was retrieved retrospectively from medical records of 618 patients who had been diagnosed as non-small cell lung cancer (NSCLC) in tertiary university hospital from 2000 through 2007. The analysis was confined to 146 subjects of stage IIIb or IV NSCLC over 70 years old. Results: The mean age at diagnosis was 77 years old (range: 70-95). In good performance group (ECOG, 0-1) was 109 patients (75%) and bad performance group (ECOG, 2-3) was 37 (25%). The mean survival time following the diagnosis was 10.0±12.8 months (m). As compared to BSC (n=92), the curative treatment (CT) group (n=54) showed the better survival rate (CT median 7±0.9 m, 95% confidence interval [CI]: 5.2-8.8 vs. BSC median 4±0.8 m, 95% CI: 2.3-5.7, p= 0.008). Within good performance group, the better survival rate was also shown in curative treatment group than BSC. Contrarily, within bad performance group, there was no significant survival gain in curative treatment over BSC. Conclusions: In over 70 years old, the survival benefit was observed in curative treatment, especially in good performance status, compared to best supportive care. In relatively poor performance status, although the outcome of survival time had a little superior tendency in curative treatment, meticulous attention should be given in treatment decision.