title: Treatment of lung cancer in the elderly: Influence of comorbidity on toxicity and survival.
abstract: BACKGROUND
  More than 50% of new cases of lung cancer (LC) are diagnosed in elderly patients. It is necessary to know correct treatment of these patients but there is a lack of evidence-based data regarding this age group, leading to an undertreatment based on a supposed lack of tolerance to radical treatments.
  
  
  OBJECTIVE
  To evaluate the results of radiotherapy (RT) treatment in elderly patients with LC in our institution and the relation between survival, toxicity and comorbidities.
  
  
  METHODS
  We retrospectively analyzed all patients over 70 years old with LC, treated with RT with or without chemotherapy (CT), in the radiotherapy department of the Instituto Português de Oncologia do Porto Francisco Gentil (IPOPFG), between January 2000 and December 2007.
  
  
  RESULTS
  Three-year overall survival (OS) rate was 33.8%. Median progression free survival was 18.1 months. For patients treated with exclusive radical radiotherapy the 3-year OS rate was 51.5% and for patients treated with sequential and concurrent CTRT, 3-year survival rates were 44% and 25.4%, respectively. We did not find a statistical relationship between the presence of comorbidities and survival. Toxicity presented by the patients was not influenced by comorbidities and did not influence survival.
  
  
  CONCLUSIONS
  Our results allow us to conclude that elderly patients are likely to benefit from radical treatments. Chemo-radiotherapy seems to increase survival but should be used carefully in old patients outside clinical trials. Comorbidities did not seem to influence survival and toxicity of treatments, although larger studies are necessary to prove this.
authors.affiliation: Radiation Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, EPE (Portuguese Institute of Oncology - Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Cardia
authors.affiliation: Radiation Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, EPE (Portuguese Institute of Oncology - Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.
authors.forename: Cármen
authors.initials: C
authors.lastname: Calçada
authors.affiliation: Radiation Oncology Department, Instituto Português de Oncologia do Porto Francisco Gentil, EPE (Portuguese Institute of Oncology - Porto), Rua Dr. António Bernardino de Almeida, 4200-072 Porto, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Pereira
keywords: Comorbidity; Elderly; Lung cancer; Radiotherapy; Toxicity