Lung Cancer Therapy Benefits Even Eldest Patients

Abstract

SYDNEY – Age should not be a barrier to chemotherapy for lung cancer, even in patients over age 70, based on the results of a retrospective study in Sweden. Nearly one-third (32.2%) of 659 patients over age 70 with non–small cell lung cancer received no radiotherapy or chemotherapy, according to data from patients who presented at a single center between 2003 and 2006. Around one-quarter received chemotherapy, 13.9% received surgery, and 10% received second-line chemotherapy, according to data presented at a world conference on lung cancer. Median survival was 231 days for patients aged 70-75 years, 250 days for those aged 76-80 years, and 213 days for those aged over 80 years. Hirsh Koyi, MD, said that he and his fellow researchers on the study were surprised to discover how many patients over 70 did not receive any treatment at all. In their own practices, they have generally heard concerns that patients over 70 were more prone to other diseases such as kidney or heart disease, Dr. Koyi said in an interview. However, the patient population was generally healthy and in good shape, which raised questions about why they did not receive the same treatment as younger patients, said Dr. Koyi, of Gävle (Sweden) Hospital. Older patients “are undertreated and discriminated against without any reason. We have patients who are older than 80 years and, with surgery, are living still after 10 years,” he said. No prospective study has directly addressed chemotherapy in this age group, he said. He said patients over 70 years with a performance status score of 1-2, with good kidney and heart function, and in otherwise good health should be considered for chemotherapy. “We have to encourage our colleagues to look not at the age but at how each patient feels.” The conference was sponsored by the International Association for the Study of Lung Cancer.