title: Negligible influence of comorbidity on prognosis of patients with small cell lung cancer: a population-based study in the Netherlands.
abstract: Management of small cell lung cancer (SCLC) among elderly is complex because of decreased organ functions and interactions with comorbidity. Since elderly patients are often excluded from clinical trials, little is known about the way they are treated and outcome. We evaluated the prognostic effects of rising age and comorbidity in unselected Dutch SCLC patients (Eindhoven Cancer Registry). Elderly patients received chemotherapy less often and the dose was also reduced more often. Cardiovascular diseases, hypertension or diabetes lowered the proportion receiving combined chemotherapy and radiotherapy among patients with limited disease. About 80% of the patients receiving chemotherapy suffered from a side effect, which was not related to age. After adjustment for age, gender, stage and treatment modality, comorbidity had a negligible prognostic effect. Chemotherapy (in combination with radiotherapy) seemed to improve survival, however, toxicity and quality of life in these patients should be evaluated thoroughly in future randomized studies.
authors.affiliation: Eindhoven Cancer Registry, Comprehensive Cancer Centre South, P.O. Box 231, 5600 AE Eindhoven, The Netherlands. research@ikz.nl
authors.forename: M L G
authors.initials: ML
authors.lastname: Janssen-Heijnen
authors.forename: V E P P
authors.initials: VE
authors.lastname: Lemmens
authors.forename: B E E M
authors.initials: BE
authors.lastname: van den Borne
authors.forename: B
authors.initials: B
authors.lastname: Biesma
authors.forename: S B
authors.initials: SB
authors.lastname: Oei
authors.forename: J W W
authors.initials: JW
authors.lastname: Coebergh
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011379:Prognosis; D011878:Radiotherapy; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents