Abstract
More than 60% of lung cancer patients in Europe and the USA are older than 65 years at the time of diagnosis. Despite this, elderly patients are generally under-represented in clinical trials. That being so, a general consensus on how to treat elderly patients is still far from being achieved. In this review, we address some of the issues and challenges surrounding the treatment of older cancer patients and radiochemotherapy. We discuss the existing evidence related to radio-chemotherapy in the elderly, focusing primarily on the lung cancer (NSCLC and SCLC) most commonly seen in older patients, and making general treatment recommendations.
Highlights
Lung cancer is the leading cause of cancer deaths in the United States and worldwide [1] and it is a typical cancer of elderly patients
We address some of the issues and challenges surrounding the treatment of older cancer patients and radiochemotherapy
As the survival of elderly population increases in developed countries worldwide, it is expected that oncologists will be increasingly confronted with the therapeutic challenge of an elderly patient presenting with NSCLC or SCLC
Summary
Lung cancer is the leading cause of cancer deaths in the United States and worldwide [1] and it is a typical cancer of elderly patients. It is widespread that radiochemotherapy is standard treatment for unresectable non small cell lung cancerand for small cell lung cancer; in elderly cancer patients there is no clear evidence of safety and efficacy of radiochemotherapy approach. Since elderly patients are an extremely heterogeneous population, subjects can vary from very fit to not being able to live independently due to co-morbidities, it is not so clear whether the toxicity of treatment is justified by the level gained as measured by life prolongation and whether co-morbidities can influence the acute and late toxicities due to radiochemotherapy. There is a lack of clinical trials to drive evidence-based decision making in the elderly lung cancer patients, we review some of the important studies germane to the lung cancer radiochemotherapy treatment in elderly patients
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