title: Incidence of chemotherapy discontinuation and characteristics of elderly patients with non-small cell lung cancer treated with platinum-based doublets.
abstract: OBJECTIVE
  To compare patient's characteristics, clinical data, and rates of chemotherapy discontinuation in advanced NSCLC (non-small cell lung cancer) patients treated with platinum-based association chemotherapy (elderly vs. younger counterparts). To evaluate if there are certain factors that can predict discontinuation of chemotherapy.
  
  
  METHODS
  A retrospective analysis of all cases of advanced NSCLC treated with either cisplatin-gemcitabine or cisplatin-vinorelbine at the Regional Institute of Oncology Iaşi between January 2012 and December 2013 was performed. Patients were divided into two groups: over 70 years old and under 70 years old. Patient's characteristics and clinical data (including whether or not the patient discontinued treatment) were recorded for each case.
  
  
  RESULTS
  The elderly patients had more comorbidities (p = 0.003), were prescribed a larger number of pills (p = 0.02), and had longer periods of hospitalisation (p = 0.005). No difference in toxicity was noted between the two groups. Five patients chose to discontinue chemotherapy in the elderly group. Only two patients made the same choice (p = 0.02) in the younger group. Correlation analysis revealed that refusal of further chemotherapy was associated with the length of hospital stay, number of pills per day, and smoking status.
  
  
  CONCLUSIONS
  Geriatricians should minimise iatrogeny and polypharmacy by optimising long-term treatment. This will increase the chance that elderly patients will not discontinue chemotherapy. Hospital stay should be reduced to a minimum. As life span increases so does the number of elderly patients with cancer; it is vital to understand and prevent the causes of chemotherapy discontinuation in order to achieve optimal therapeutic results.
authors.affiliation: Regional Institute of Oncology, Iaşi, Romania.
authors.forename: Teodora
authors.initials: T
authors.lastname: Alexa
authors.affiliation: Pneumology Hospital, Iaşi, Romania.
authors.forename: Anti
authors.initials: A
authors.lastname: Lavinia
authors.affiliation: University of Medicine and Pharmacy "Grigore T. Popa", Iaşi, Romania.
authors.forename: Andrei
authors.initials: A
authors.lastname: Luca
authors.affiliation: Oncology Department, University of Medicine and Pharmacy "Grigore T. Popa", Iaşi, Romania.
authors.forename: Lucian
authors.initials: L
authors.lastname: Miron
authors.affiliation: Geriatrics Department, University of Medicine and Pharmacy "Grigore T. Popa", Iaşi, Romania.
authors.forename: Ioana Dana
authors.initials: ID
authors.lastname: Alexa
keywords: chemotherapy; elderly; non-small cell lung cancer; treatment refusal