title: Management of elderly patients with advanced non-small cell lung cancer: a single-center experience.
abstract: BACKGROUND
  Optimal management of elderly patients (≥70 years) with non-small cell lung cancer (NSCLC) remains debatable. We compared survival and treatment of advanced NSCLC between elderly and younger patients.
  
  
  METHODS
  From the cancer registry, we identified 188 patients treated with chemotherapy for stage IV NSCLC. Patient characteristics, survival, toxicity, chemotherapy regimen and response were compared between age groups (patients 50-69 vs. ≥70 years).
  
  
  RESULTS
  There were 96 young and 92 elderly patients. The majority were male (70%) and had adenocarcinoma (53%). More elderly had an ECOG performance status >1 (59 vs. 42%, p = 0.04). Median survival was longer for young patients (11.5 vs. 10.8 months, hazard ratio, HR 1.43, p = 0.04). Patients ≥75 years had a significantly worse outcome compared to the young and patients aged 70-74 years (11.5 vs. 12.8 vs. 7.7 months, HR 1.71, p = 0.01). Hospitalization rate did not differ. Elderly had more hematological toxicities (56 vs. 32%, p = 0.01) and less frequently received first-line platinum combinations (96 vs. 69%, p < 0.001).
  
  
  CONCLUSIONS
  Elderly patients had a marginally worse survival compared to young patients. Despite the less frequent use of combination chemotherapy, elderly patients experienced toxicity more often. Survival of those ≥75 years was significantly worse, indicating the urgent need of further research particularly in this age group.
authors.affiliation: Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland. martin.frueh@kssg.ch
authors.forename: M
authors.initials: M
authors.lastname: Früh
authors.forename: H
authors.initials: H
authors.lastname: Besrour
authors.forename: S
authors.initials: S
authors.lastname: Gillessen
authors.forename: M
authors.initials: M
authors.lastname: Joerger
authors.forename: F
authors.initials: F
authors.lastname: Hitz
authors.forename: A
authors.initials: A
authors.lastname: Savidan
authors.forename: T
authors.initials: T
authors.lastname: Cerny
authors.forename: S
authors.initials: S
authors.lastname: Ess
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D016190:Carboplatin; D017239:Paclitaxel