title: Treatment and survival of patients with small-cell lung cancer: small steps forward, but not for patients >80.
abstract: BACKGROUND
  Seventy-five percent of newly diagnosed patients with small-cell lung cancer (SCLC) are aged 60+ and quite a few are treated less aggressively because of fear of toxic effects. We described trends in treatment and survival of unselected SCLC patients.
  
  
  METHODS
  For the present study, all 13,007 SCLC patients aged 60+ diagnosed in The Netherlands from 1997 to 2007 were included.
  
  
  RESULTS
  Among patients with limited disease, the proportion receiving chemoradiation increased from 35% to almost 60% for those aged 60-69, from 28% to 48% in age group 70-74, from 17% to 33% in age group 75-79, but remained <10% for those aged 80+. Among patients with extensive disease, the proportion receiving chemotherapy (CT) decreased from 81% of patients aged 60-64 to 23% of those aged 85+, without substantial changes over time. Survival has only improved for patients <80 years.
  
  
  CONCLUSIONS
  CT (+radiotherapy) has improved survival for unselected SCLC patients <80. A better understanding of the impact of frailty on completion of treatment and toxic effects among patients aged 80+ would enable the treating physician to anticipate toxic effects better and to discuss risks and benefits of treatment with the patient.
authors.affiliation: Department of Research, Eindhoven Cancer Registry, Comprehensive Cancer Centre South, Eindhoven, The Netherlands. research@ikz.nl
authors.forename: M L G
authors.initials: ML
authors.lastname: Janssen-Heijnen
authors.forename: H A A M
authors.initials: HA
authors.lastname: Maas
authors.forename: S
authors.initials: S
authors.lastname: Siesling
authors.forename: C C E
authors.initials: CC
authors.lastname: Koning
authors.forename: J W W
authors.initials: JW
authors.lastname: Coebergh
authors.forename: H J M
authors.initials: HJ
authors.lastname: Groen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy; D016019:Survival Analysis