P1.06-008 Non-Small Cell Lung Cancer in Octogenarians: Real-Life Clinical Practice; Characteristics, Therapy and Survival

Abstract

Globally, more people are surviving to older age; consequently, an increasing proportion of cancer patients are aged >65 years and many are aged >70 years. Treatment of the elderly with lung cancer has, therefore, become an important issue. We performed a retrospective study of our patients to demonstrate how octogenarians with non-small cell lung cancer (NSCLC) are treated in real-life clinical practice. A retrospective observational study of all elderly (≥80 years) patients with NSCLC referred to Department of Respiratory Medicine and Allergy, Karolinska Hospital, Sweden, 2003-2010 and followed until June, 2016. During the period 2662 patients were newly diagnosed with lung cancer. 485 (12.2%) were 80 years or older. 33 (6.8%) hade small cell lung cancer and were excluded, leaving 452 for the study. 216 (47.8%) were male. Mean, median, and range age for males were 83.8, 83, and 80-96 years, respectively. These figures for females were 83.7, 83, and 86-95. 28 (6.2%) of the population were 90 years old or older. 77.8% patients were current or former smokers with significant differences between the genders (p<0.001). There was no difference in performance status (PS) between the genders (p<0.93), with PS 0-1 in 45%, PS2 in 26% and PS3-4 in 29%. 33.9% of patients were diagnosed in stages 1-II, 34.1% in stage III and 31.9% in stage IV. Most of the patients, 45.6%, had adenocarcinoma, 18.1% squamous cell carcinoma, while histological diagnosis was unavailable in 23.2%. There were significant differences in treatment modalities (p=0.040). Chemotherapy was given in 9.5%, local radiotherapy in 17%, stereotactic body radiotherapy (SBRT) in 10.6%, 6.9% underwent surgery and 209 (46.2%) were not given any therapy. Second-line chemotherapy was given in 4% and third-line in 1.5%. Only one patient received fourth line. Median overall survival was 115 days in patients given no therapy and 362 days in patients given any therapy. Patients who underwent surgery had a median overall survival of 5,6 years compared to 3,5 years for patients given SBRT (p=0.0187). There were no significant differences in survival between genders. Treatment of NSCLC patients 80 years and older with any modality is feasible with a good PS. Survival is fairly good with surgery or SBRT.