Clinical patterns and treatment outcome of elderly patients in clinical stage IB/II non-small cell lung cancer.
OBJECTIVE
Surgery is a standard treatment in patients with clinical stage IB/II non-small cell lung cancer (NSCLC). We often have difficulty in treating of elderly patients due to their insufficient physiological function. To better manage such elderly patients, the clinical characteristics and prognosis of patients with these stages, who were 75 years of age or older, were reviewed.


METHODS
From 1972 to 1999, 112 elderly patients with these stages were treated in our department. These patients comprised 88 men and 24 women. The histological types were 50 adenocarcinomas, 51 squamous cell carcinomas, 8 large cell carcinomas, and 3 adenosquamous carcinomas.


RESULTS
Seventy-four patients (66%) underwent a surgical resection, including 60 surgery alone, 14 combined modality therapy. Radiotherapy, with or without chemotherapy, was given to 30 patients (27%), and chemotherapy alone to 5 (4.5%). In addition, 3 (2.7%) were given no therapy. The survivals of the surgery group at 2 and 5 years are 53% and 21% and those of the radiotherapy group are 35% and 3%, respectively. A multivariate analysis in radiotherapy group shows the predominant prognostic factor to be adenocarcinoma. The 2-year survival of the radiotherapy group in patients with adenocarcinoma is 58%, while that of patients with squamous cell carcinoma is 22%.


CONCLUSIONS
These above observations suggest that radiotherapy is an alternative strategy for patients who cannot undergo surgery, especially with adenocarcinoma.
Okamoto
Tatsuro
T
Department of Thoracic Oncology, National Kyushu Cancer Center, Fukuoka, Japan. tokamoto@nk-cc.go.jp
Maruyama
Riichiroh
R
Shoji
Fumihiro
F
Ikeda
Jiro
J
Miyamoto
Tetsuya
T
Nakamura
Tomomi
T
Asoh
Hiroshi
H
Ichinose
Yukito
Y
D000230:Adenocarcinoma / Q000532:radiotherapy; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000401:mortality; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D016019:Survival Analysis; D016896:Treatment Outcome