title: Chemotherapy is beneficial for elderly patients with advanced non-small-cell lung cancer: analysis of patients aged 70-74, 75-79, and 80 or older in Japan.
abstract: BACKGROUND
  It remains to be determined in elderly patients with advanced non-small-cell lung cancers (NSCLCs) if there is a benefit of chemotherapy in patients aged 80 or older.
  
  
  METHODS
  Using a database from the Japan National Hospital Organization Study Group for Lung Cancer from 1990 to 2005, 3 cohorts based on the age of diagnosis were examined in patients with stage IIIB and IV NSCLC. Cohort 1 was for 70- to 74-year-old patients, cohort 2 for 75- to 79-year old, and cohort 3 for 80 years and older (80+). Multivariate analysis of survival for each cohort was performed using the Cox regression method using the following covariates: age, PS, histology, stage, smoking status, and chemotherapy.
  
  
  RESULTS
  There were 1617 patients in cohort 1, 1349 in cohort 2, and 1010 in cohort 3. The number of patients treated with chemotherapy were 991 (61%) in cohort 1, 648 (48%) in cohort 2, and 286 (28%) in cohort 3. Multivariate analysis for overall survival (OS) showed that chemotherapy was a significant prognostic factor among cohort 1 (hazard ratio [HR], 0.540; 95% confidence interval [CI], 0.481-0.607; P < .0001) and cohort 2 (HR, 0.715; 95% CI, 0.632-0.810; P < .0001) and showed a benefit trend among cohort 3 (HR, 0.869; 95% CI, 0.742-1.018; P = .0940).
  
  
  CONCLUSIONS
  After adjustment for PS, a trend of survival benefit of chemotherapy remained in patients aged 80 or older.
authors.affiliation: National Hospital Organization (NHO) Kinki-Chuo Chest Medical Center, Osaka, Japan. t-kawaguchi@kch.hosp.go.jp
authors.forename: Tomoya
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tamiya
authors.forename: Atsuhisa
authors.initials: A
authors.lastname: Tamura
authors.forename: Masamichi
authors.initials: M
authors.lastname: Arao
authors.forename: Ryusei
authors.initials: R
authors.lastname: Saito
authors.forename: Akihide
authors.initials: A
authors.lastname: Matsumura
authors.forename: Sai-Hong I
authors.initials: SH
authors.lastname: Ou
authors.forename: Taro
authors.initials: T
authors.lastname: Tamura
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents