Chemotherapy may be underused in elderly with lung cancer

Chemotherapy can improve median survival by more than 6 months in elderly persons with small cell lung cancer (SCLC), even those over the age of 80 years, a retrospective cohort study has indicated.

In the analysis of data from 10,428 patients aged 65 years and older who received a diagnosis of SCLC between 1992 and 2001, 67.1% were administered chemotherapy, with the most common regimens combining etoposide with either cisplatin or carboplatin, with or without other agents. In addition, 39.1% of the patients underwent radiation and 3.4% had surgery; 21.8% received no treatment.

Median survival for all patients was 7 months. The researchers reported in Journal of Thoracic Oncology (2013;8[10]:1272-1281) that chemotherapy was found to provide a 6.5-month improvement in median survival. Yet, as they noted, one-sixth of elderly persons with SCLC are never referred to a medical oncologist, and one-third never receive chemotherapy. In this study, patients aged 85 years and older were significantly less likely than patients aged 65 to 69 years to undergo chemotherapy.

Factors associated with improved survival were being female, being black, having limited-stage disease, receiving any treatment, and having a lower comorbidity score.
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