BACKGROUND: Seventy-five percent of newly diagnosed patients with small-cell lung cancer (SCLC) are aged 60+ and quite a few are treated less aggressively because of fear of toxic effects. We described trends in treatment and survival of unselected SCLC patients. PATIENTS AND METHODS: For the present study, all 13,007 SCLC patients aged 60+ diagnosed in The Netherlands from 1997 to 2007 were included. RESULTS: Among patients with limited disease, the proportion receiving chemoradiation increased from 35% to almost 60% for those aged 60-69, from 28% to 48% in age group 70-74, from 17% to 33% in age group 75-79, but remained <10% for those aged 80+. Among patients with extensive disease, the proportion receiving chemotherapy (CT) decreased from 81% of patients aged 60-64 to 23% of those aged 85+, without substantial changes over time. Survival has only improved for patients <80 years. CONCLUSIONS: CT (+radiotherapy) has improved survival for unselected SCLC patients <80. A better understanding of the impact of frailty on completion of treatment and toxic effects among patients aged 80+ would enable the treating physician to anticipate toxic effects better and to discuss risks and benefits of treatment with the patient.
BACKGROUND: Seventy-five percent of newly diagnosed patients with small-cell lung cancer (SCLC) are aged 60+ and quite a few are treated less aggressively because of fear of toxic effects. We described trends in treatment and survival of unselected SCLCpatients. PATIENTS AND METHODS: For the present study, all 13,007 SCLCpatients aged 60+ diagnosed in The Netherlands from 1997 to 2007 were included. RESULTS: Among patients with limited disease, the proportion receiving chemoradiation increased from 35% to almost 60% for those aged 60-69, from 28% to 48% in age group 70-74, from 17% to 33% in age group 75-79, but remained <10% for those aged 80+. Among patients with extensive disease, the proportion receiving chemotherapy (CT) decreased from 81% of patients aged 60-64 to 23% of those aged 85+, without substantial changes over time. Survival has only improved for patients <80 years. CONCLUSIONS: CT (+radiotherapy) has improved survival for unselected SCLCpatients <80. A better understanding of the impact of frailty on completion of treatment and toxic effects among patients aged 80+ would enable the treating physician to anticipate toxic effects better and to discuss risks and benefits of treatment with the patient.
Authors: Karlijn J G Schulkes; Carin A M Pouw; Elisabeth J M Driessen; Leontine J R van Elden; Frederiek van den Bos; Maryska L G Janssen-Heijnen; Jan-Willem J Lammers; Marije E Hamaker Journal: Lung Date: 2017-06-19 Impact factor: 2.584
Authors: Aamir Khakwani; Anna L Rich; Laila J Tata; Helen A Powell; Rosamund A Stanley; David R Baldwin; Richard B Hubbard Journal: PLoS One Date: 2014-02-21 Impact factor: 3.240