title: Karnofsky Performance Score, Radiation Dose and Nodal Status Predict Survival of Elderly Patients Irradiated for Limited-disease Small-cell Lung Cancer.
abstract: OBJECTIVE
  Elderly patients require special consideration in oncology treatment. Small-cell lung cancer (SCLC) is a highly aggressive tumour with dismal prognosis. The present study focused on prognostic factors in elderly patients irradiated for limited-disease SCLC.
  
  
  METHODS
  In 36 patients aged ≥65 years, 11 factors were evaluated for the impact on survival, namely gender, Karnofsky performance score, body mass index, T-category, N-category, tobacco consumption, time from SCLC diagnosis to irradiation, smoking during irradiation, simultaneous chemotherapy, radiation dose and prophylactic cranial irradiation.
  
  
  RESULTS
  On multivariate analysis, Karnofsky performance score of >70 (p<0.001), N-category 0-2 (p≤0.001) and total radiation dose of >52 Gy (p=0.011) were significantly associated with better survival.
  
  
  CONCLUSIONS
  Significant predictors of survival in elderly patients irradiated for limited-disease SCLC were identified. A radiation dose of >52 Gy resulted in improved survival when compared to lower doses.
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany LKaesmann@gmail.com.
authors.forename: Lukas
authors.initials: L
authors.lastname: Käsmann
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Practice of Radiotherapy and Radiation Oncology, Hannover, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Janssen
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D016190:Carboplatin; D002945:Cisplatin
keywords: SCLC; limited disease; prognostic factors; radiation dose; radiation therapy; survival