Steven E Schild1, Liming Zhao2, Jason A Wampfler3, Thomas B Daniels4, Terence Sio4, Helen J Ross5, Harshita Paripati5, Randolph S Marks6, Joanne Yi7, Han Liu8, Yanqi He9, Ping Yang10. 1. Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ. Electronic address: sschild@mayo.edu. 2. Department of Health Sciences Research, Mayo Clinic, Rochester, MN. 3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN. 4. Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ. 5. Division of Medical Oncology, Mayo Clinic, Phoenix, AZ. 6. Department of Medical Oncology, Mayo Clinic, Rochester, MN. 7. Department of Pathology, Mayo Clinic, Rochester, MN. 8. Department of Health Sciences Research, Mayo Clinic, Scottsdale, AZ; Department of Respiratory Medicine, The First Hospital of Jilin University, Changchun, China. 9. Department of Health Sciences Research, Mayo Clinic, Scottsdale, AZ; Department of Respiratory Medicine, West China Hospital of Sichuan University, Chengdu, China. 10. Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Department of Health Sciences Research, Mayo Clinic, Scottsdale, AZ.
Abstract
BACKGROUND: This analysis was performed to describe the outcome of very elderly (≥ 80 years) patients with small-cell lung cancer (SCLC) as there is no published data regarding these patients. MATERIALS AND METHODS: One hundred forty-six very elderly patients with SCLC were identified from the Institutional Lung Cancer Database ranging in age from 80 to 92 years (median, 82 years). Of these, 47 (32%) patients had limited-stage SCLC (L-SCLC), and 99 (68%) had extensive-stage SCLC (E-SCLC). All were Caucasian, and the majority (64%) were female. Sixty-seven (46%) patients had Zubrod performance status (PS) of 0 to 1. RESULTS: Of the 146 patients, 44 (30%) received no therapy, 65 (45%) received chemotherapy alone, 27 (19%) received chemotherapy plus local therapy (thoracic radiotherapy [TRT] or surgery), and 10 (7%) received local therapy alone. The median survival was 5.4 months. On univariable analysis, age (P = .019), stage (L-SCLC vs. E-SCLC; P = .0002), PS (P < .0001), and treatment option (P < .0001) were associated with survival. On multivariable analysis, stage (P = .011), PS (P = .029), and treatment option (P < .0001) maintained significance. For entire cohort, the median survival was 1.3 months without active therapy, 6 months with local therapy alone, 7.2 months with chemotherapy alone, and 14.4 months with chemotherapy plus local therapy (P < .0001, univariable and multivariable). Similar survival findings in response to treatment were found when the L-SCLC and E-SCLC cohorts were separately analyzed. CONCLUSIONS: The survival of very elderly patients with SCLC was associated with stage (L-SCLC vs. E-SCLC), PS, and treatment option. Very elderly patients with SCLC often have limited functional reserve required to tolerate aggressive multimodality therapy but appeared to benefit from it. Geriatric assessments, careful monitoring, and extra support are warranted in elderly patients. Care should be individualized based on the desires and needs of each patient.
BACKGROUND: This analysis was performed to describe the outcome of very elderly (≥ 80 years) patients with small-cell lung cancer (SCLC) as there is no published data regarding these patients. MATERIALS AND METHODS: One hundred forty-six very elderly patients with SCLC were identified from the Institutional Lung Cancer Database ranging in age from 80 to 92 years (median, 82 years). Of these, 47 (32%) patients had limited-stage SCLC (L-SCLC), and 99 (68%) had extensive-stage SCLC (E-SCLC). All were Caucasian, and the majority (64%) were female. Sixty-seven (46%) patients had Zubrod performance status (PS) of 0 to 1. RESULTS: Of the 146 patients, 44 (30%) received no therapy, 65 (45%) received chemotherapy alone, 27 (19%) received chemotherapy plus local therapy (thoracic radiotherapy [TRT] or surgery), and 10 (7%) received local therapy alone. The median survival was 5.4 months. On univariable analysis, age (P = .019), stage (L-SCLC vs. E-SCLC; P = .0002), PS (P < .0001), and treatment option (P < .0001) were associated with survival. On multivariable analysis, stage (P = .011), PS (P = .029), and treatment option (P < .0001) maintained significance. For entire cohort, the median survival was 1.3 months without active therapy, 6 months with local therapy alone, 7.2 months with chemotherapy alone, and 14.4 months with chemotherapy plus local therapy (P < .0001, univariable and multivariable). Similar survival findings in response to treatment were found when the L-SCLC and E-SCLC cohorts were separately analyzed. CONCLUSIONS: The survival of very elderly patients with SCLC was associated with stage (L-SCLC vs. E-SCLC), PS, and treatment option. Very elderly patients with SCLC often have limited functional reserve required to tolerate aggressive multimodality therapy but appeared to benefit from it. Geriatric assessments, careful monitoring, and extra support are warranted in elderly patients. Care should be individualized based on the desires and needs of each patient.
Authors: Umit Tapan; Vanessa Fiorini Furtado; Muhammad Mustafa Qureshi; Peter Everett; Kei Suzuki; Kimberley S Mak Journal: JTO Clin Res Rep Date: 2020-10-20
Authors: Bin Zhou; Qiuyuan Li; Linlin Qin; Zhao Li; Kaiqi Jin; Jie Dai; Yuming Zhu; Yang Yang; Salma K Jabbour; Alfredo Tartarone; Calvin S H Ng; Alfons Navarro; Cecilia Pompili; Gening Jiang Journal: Transl Lung Cancer Res Date: 2021-10