Abstract

Purpose: We reviewed data from our hospital-based cancer registry and chart records to determine if non-small lung cancer (NSCLC) patients older than eighty years benefit from specific treatment.Patients and Methods: Data of demographics, stage, histology, initial treatment modality, and survival status were obtained from all NSCLC patients older than eighty years registered at Taipei Veteran General Hospital from 1996 to 2000 (before era of targeted therapy). Patient survival and clinical characteristics were analyzed and compared statistically.Results: From 1996 to 2000, 6906 patients with lung cancer were diagnosed in our hospital, including 5148 (74.5%) with NSCLC. Of all NSCLC patients, 245 were older than eighty years, including 139 in the treatment group (TG) and 106 in the supportive care group (SCG). Specific treatment for patients in TG consisted of surgery, chemotherapy, and/or primary radiotherapy. The median survival time was 8 months in the TG and 3 months in the SCG (p<0.001). The 1-year survival rate was 36% in the TG and 18.9% in the SCG. Patients in the SCG had a worse performance status and more advanced stage than those in the TG (p<0.001 and p=0.001, respectively). Multivariate analysis by Cox regression identified performance status, stage and identity as veteran as independent predictors for survival. When patients with stage ⅢB or Ⅳ and a performance status of 0 to 2 were considered, patients who received radiotherapy, chemotherapy and supportive care alone had median survivals of 6, 7 and 4 months, respectively (p=0.703). Stage Ⅳ patients with a performance status of 0 to 2 had a median survival of 8 months in TG and 3 months in SCG (p=0.165).Conclusions: Very old patients with advanced NSCLC may benefit from specific treatment, such as surgery, radiotherapy, or chemotherapy, although without statistical significance.

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