title: Gemcitabine and low dose carboplatin in the treatment of elderly patients with advanced non-small cell lung cancer.
abstract: BACKGROUND
  Fifty percent of lung cancers arise in patients over 65 years old and 30% in those over 70. The aim of this study was to evaluate response, survival and tolerability of the combination carboplatin-gemcitabine in elderly patients with advanced non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Between May 1998 and December 2000, 88 patients were included. Median age was 74 (range 65-83). Treatment consisted of gemcitabine 1250 mg/m(2) (1000 mg/m(2) in the first six patients) on days 1 and 8, and carboplatin AUC=4 on day 1, every 21 days. Prognostic factors for survival were analysed. Performance status (PS) and symptoms were evaluated before and after three and six courses.
  
  
  RESULTS
  A total of 400 cycles were administered (median of four per patient). WHO grades 3-4 toxicities were: neutropenia in 13% of the cycles, thrombocytopenia and anaemia in 4.5 and 14.7% of patients in any cycle. There was one treatment-related death. According to the intent-to-treat analysis, 33 patients achieved objective response, 33 had stable disease, and 22 had treatment failure (progression in 18 patients). Median and 1 year survival were 9 months and 34%, respectively. Median time to progression was 8 months. Only disease stage and PS showed independent prognostic value. Comorbidity and PS displayed no close correlation. Symptom improvement was seen as follows: pain (61.7%), dyspnea (50%), haemoptysis (80%), anorexia (62.5%) and asthenia (61.5%).
  
  
  CONCLUSIONS
  The combination carboplatin-gemcitabine at these doses is feasible in elderly patients with advanced non-small cell lung cancer. Tolerability and toxicity are acceptable. Response rate and survival stand in the range of the most active regimens. Comorbidity and PS showed prognostic independence.
authors.affiliation: Department of Oncology, Hospital Virgen de Los Lirios, Poli;gono de Caramanxel s/n, 03804 Alcoy, Spain. mm@falcon-es.com
authors.forename: I
authors.initials: I
authors.lastname: Maestu
authors.forename: L
authors.initials: L
authors.lastname: Gómez-Aldaraví
authors.forename: M D
authors.initials: MD
authors.lastname: Torregrosa
authors.forename: C
authors.initials: C
authors.lastname: Camps
authors.forename: C
authors.initials: C
authors.lastname: Llorca
authors.forename: C
authors.initials: C
authors.lastname: Bosch
authors.forename: J
authors.initials: J
authors.lastname: Gómez
authors.forename: V
authors.initials: V
authors.lastname: Giner
authors.forename: A
authors.initials: A
authors.lastname: Oltra
authors.forename: A
authors.initials: A
authors.lastname: Albert
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D016190:Carboplatin; D000093542:Gemcitabine