Cisplatin-based combination chemotherapy for elderly patients with non-small-cell lung cancer.
OBJECTIVE
To compare the response rates, toxicities and survival durations of elderly patients (70 years of age or more) with those of younger patients (less than 70 years of age) with non-small-cell lung cancer (NSCLC) treated with cisplatin-based chemotherapy.


METHODS
We analyzed retrospectively the data of 203 assessable patients entered on a prospective randomized trial of cisplatin-based combination chemotherapy. Chemotherapy consisted of three dosage regimens: (1) vindesine and cisplatin (VP); (2) mitomycin, vindesine and cisplatin (MVP); or (3) etoposide and cisplatin alternating with vindesine and mitomycin (EP/VM).


RESULTS
A greater proportion of elderly patients had localized disease and more squamous cell carcinoma than non-elderly patients. The overall response rates were 44% in the elderly group and 28% in the non-elderly group. In the EP/VM arm, the response rate was significantly better in the elderly group than in the non-elderly group. The frequency of grade 4 leukocytopenia in the MVP and EP/VM arms in the elderly group was significantly greater than in the non-elderly group (P < 0.05). No differences were found in nonhematological toxicities between the two groups. There was no difference in overall survival between the groups.


CONCLUSIONS
Elderly patients treated with mitomycin-containing regimens have higher hematologic toxicities than younger patients. The results of this study are consistent with the previously reported pharmacologic data on mitomycin suggesting altered pharmacokinetics in elderly patients. The improved response rate in the elderly patients was probably because more elderly patients had earlier disease, squamous cell carcinoma and better performance status. Cisplatin-based chemotherapy was tolerable for most elderly NSCLC patients with good performance status.
Kubota
K
K
Department of Internal Medicine, National Kinki Central Hospital for Chest Diseases, Osaka, Japan.
Furuse
K
K
Kawahara
M
M
Kodama
N
N
Ogawara
M
M
Takada
M
M
Masuda
N
N
Negoro
S
S
Matsui
K
K
Takifuji
N
N
Kudoh
S
S
Kusunoki
Y
Y
Fukuoka
M
M
D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D016685:Mitomycin / Q000008:administration & dosage; D012189:Retrospective Studies; D014751:Vindesine / Q000008:administration & dosage
D016685:Mitomycin; D002945:Cisplatin; D014751:Vindesine