title: Trends and predictors of first-line chemotherapy use among elderly patients with advanced non-small cell lung cancer in the United States.
abstract: OBJECTIVE
  This study assessed first-line chemotherapy treatment patterns over time and identified predictors of chemotherapy use and treatment selection among elderly patients with newly diagnosed Stage IIIB/IV non-small cell lung cancer (NSCLC) in the United States.
  
  
  METHODS
  Patients aged 65 years and older newly diagnosed with Stage IIIB/IV NSCLC between 1997 and 2002 were identified and followed through 2003 using the Surveillance, Epidemiology and End Results (SEER)-Medicare database to evaluate temporal trends in chemotherapy treatment. Multivariate logistic regression models were estimated to identify predictors of chemotherapy treatment and factors associated with use of cisplatin/carboplatin (platinum) and either a taxane or gemcitabine versus other treatments.
  
  
  RESULTS
  Chemotherapy use increased from approximately 28% of Stage IIIB/IV NSCLC patients diagnosed in 1997 to 36% of patients diagnosed in 2002. Doublet therapy was most commonly used as first-line therapy, received by 74% of chemotherapy-treated patients across all study years. Use of doublet therapy with platinum and either a taxane or gemcitabine also increased over time (with the largest increase for gemcitabine combinations from 0.3% in 1997 to 11.8% in 2002). Males were more likely than females to be treated with chemotherapy (odds ratios [95% CI]: 1.14 [1.06-1.22]), as were patients in the Northeast and South relative to patients in the West (1.24 [1.13-1.36] and 1.33 [1.20-1.47], respectively).
  
  
  CONCLUSIONS
  Use of first-line chemotherapy treatment among elderly Stage IIIB/IV NSCLC patients is low, but appears to be increasing, with potential regional and gender differences in treatment. These findings are likely to be of interest to clinicians and policymakers.
authors.affiliation: i3 Innovus, Medford, MA, USA.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lang
authors.forename: Martin D
authors.initials: MD
authors.lastname: Marciniak
authors.forename: Doug
authors.initials: D
authors.lastname: Faries
authors.forename: Michael
authors.initials: M
authors.lastname: Stokes
authors.forename: Don
authors.initials: D
authors.lastname: Buesching
authors.forename: Craig
authors.initials: C
authors.lastname: Earle
authors.forename: Joseph
authors.initials: J
authors.lastname: Treat
authors.forename: Nathalie
authors.initials: N
authors.lastname: Morissette
authors.forename: David
authors.initials: D
authors.lastname: Thompson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies; D018426:SEER Program