title: Comparison of single-agent chemotherapy and targeted therapy to first-line treatment in patients aged 80 years and older with advanced non-small-cell lung cancer.
abstract: OBJECTIVE
  The aim of this study was to compare single-agent chemotherapy with targeted therapy in initial treatment and to explore a better choice of treatment for patients aged 80 years and older with advanced non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  A retrospective chart review was conducted for 136 patients aged 80 years and older who were cytopathologically diagnosed and staged as advanced (stage IIIB or IV) NSCLC. The patient population was divided into two treatment groups: 78 patients were allocated to the chemotherapy group (group A, pemetrexed or gemcitabine or docetaxel as a single agent), and 60 patients were allocated to another group and received epidermal growth factor-receptor tyrosine-kinase inhibitors (group B, erlotinib or gefitinib as a single agent). The primary end points were overall survival (OS) and progression-free survival (PFS), and the secondary end points were response rate, disease-control rate, safety, and quality of life.
  
  
  RESULTS
  In group A and group B, respectively, the median PFS was 2 versus 4 months (P=0.013), and the median OS was 8 versus 16 months (P=0.025). The 1- and 2-year survival rates of the two groups were 23.7% (group A, 18 of 76) versus 76.7% (group B, 46 of 60) and 13.2% (group A, ten of 76) versus 10% (group B, six of 60), respectively. The response rate and disease-control rate were 28.9% versus 36.7% (P=0.39) and 57.9% versus 76.7% (P=0.022) in group A and group B, respectively.
  
  
  CONCLUSIONS
  Elders aged 80 years and over with advanced NSCLC in group B had longer PFS and OS compared with group A. It was well tolerated in group B because of the mild adverse effects. Targeted therapy can be considered primarily for patients aged 80 years and older with advanced NSCLC who cannot tolerate chemotherapy or radiotherapy.
authors.affiliation: School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, University of Jinan, People's Republic of China.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Oncology, Shandong Cancer Hospital, Jinan, People's Republic of China.
authors.forename: Zhehai
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Oncology, Shandong Cancer Hospital, Jinan, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Guo
authors.affiliation: Department of Oncology, Shandong Cancer Hospital, Jinan, People's Republic of China.
authors.forename: Liyan
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Oncology, Shandong Cancer Hospital, Jinan, People's Republic of China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Han
authors.affiliation: School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, University of Jinan, People's Republic of China.
authors.forename: Minmin
authors.initials: M
authors.lastname: Li
authors.affiliation: School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, University of Jinan, People's Republic of China.
authors.forename: Shu
authors.initials: S
authors.lastname: Fang
authors.affiliation: School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, University of Jinan, People's Republic of China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Bi
authors.affiliation: School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, University of Jinan, People's Republic of China.
authors.forename: Ning
authors.initials: N
authors.lastname: Tang
authors.affiliation: School of Medicine and Life Sciences, Shandong Academy of Medical Sciences, University of Jinan, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
keywords: 80 years old; chemotherapy; elderly; first-line; non-small-cell lung cancer; targeted therapy