Influence of some clinical parameters in the tolerance to treatment in elderly patients with advanced lung cancer.

Abstract

e19600 Background: Cancer represents a major clinical problem in the elderly. Two thirds of the population with lung cancer is 65 yrs or older. Lung cancer represents the first cause of death by cancer in older people.They are also more likely to present multiple comorbid conditions. They use three times more medications than younger pts. Besides, age affects the pharmacokinetics of antineoplasic agents and increases the susceptibility to complications. Methods: 130 lung cancer pts with PS (0,1,2) were included. Pts selection was conducted using General Geriatric Assessment. ADL(Activity of Daily Living) and IADL(Instrumental of Daily Living) was studied before and after treatment . Pts underwent Ch/Rxt . Pts were divided in older and younger than 70. All pts had adequate cardiac, hepatic, renal and bone marrow functions. Comorbidities studied were: hypertension, diabetes, OCLD, arrhythmia, coronary disease and digestive disease. Toxicities were studied following the WHO criteria and correlated according to age, ADL, IADL, PS, WL, comorbidities, and the use of more than 3 drugs (Polypharmacy), in addition to the treatment. QoL was assessed through the evolution of ADL, IADL and PS .Statistical Methods: Pearson's Chi-Square, Kaplan Meier's Survival tests. Results: The most frequent toxicity level in the whole sample was Grade I. No relationship was found between toxicities and age, irrespective of type and level. Toxicity level was found to be higher in the patients who used more than 3 other medications p=0.03. Pts with PS 0-1 had lower toxicity level than pts with PS 2. Statistically significant association was found between comorbidities and toxicity levels. There was improvement in Qol through ADL, PS, and IADL evolution after treatment p= 0.001. Conclusions: Older lung cancer pts in good general condition and with controlled comorbidities may receive Ch/ Rxt, if this treatment modality results in improvement of their QoL. The reason why the majority of pts had low toxicities may be attributed to the fact that all of them were properly selected. Treatment options should be tailored to older patients based on the same selection process and benefits seen in the population as a whole. No significant financial relationships to disclose.