Measurement and impact of co-morbidity in elderly patients with advanced non-small cell lung cancer treated with chemotherapy. A phase II study of weekly paclitaxel.
BACKGROUND
Aging is associated with an increasing of comorbidity and at the time of lung cancer diagnosis patients present one or more other serious disease. The aim of the study is to evaluate tolerability, response and survival of weekly paclitaxel in elderly patients with advanced NSCLC and concomitant diseases.


METHODS
Patients with advanced NSCLC who were poor candidates to platinum-based therapy because of age >65 years and coexistent illnesses received weekly paclitaxel over 1 hour at a dose of 80 mg/m2. Comorbidity was evaluated according to the Charlson scale, Kaplan-Feinstein index and the Cumulative Illness Rating Scale.


RESULTS
A total of 57 patients (median age, 74 years; range, 65-84) were included. The overall response rate was 44%. Median survival was 7.8 months. Grade 3-4 toxicity was uncommon: neutropenia 1.8%, thrombocytopenia 1.8%, neuropathy 7%, hypersensitivity reaction 1.8%. Comorbidity indexes were useful to characterize better the population of elderly patients, but did not define a subgroup with worse prognosis.


CONCLUSIONS
The low toxicity profile and efficacy of low-dose weekly paclitaxel justified its usage in this group of poor prognosis elderly patients with advanced NSCLC and comorbidities. A comorbidity index should be introduced in prospective oncological studies in the elderly to ensure compatibility.
Juan
Oscar
O
Department of Medical Oncology, Hospital Arnau de Vilanova, San Clemente 12, Valencia 46015, Spain. juan_osc@gva.es
Albert
Ana
A
Campos
Juan M
JM
Caranyana
Vicente
V
Muñoz
José
J
Alberola
Vicente
V
D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage* / Q000009:adverse effects; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000453:epidemiology*; D015897:Comorbidity; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D017239:Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D010349:Patient Compliance; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D051437:Renal Insufficiency / Q000453:epidemiology; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000453:epidemiology
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel