Advanced age no bar to lung cancer therapy

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Otherwise healthy elderly patients with small-cell lung cancer that has not advanced are able to tolerate a combination of chemotherapy and radiation therapy, with disease control and survival rates similar to those seen in their younger counterparts, researchers report in the medical journal Cancer.

“Fit elderly patients with locally advanced limited-stage small-cell lung cancer should be encouraged to receive combined-modality therapy,” lead investigator Dr. Steven E. Schild of the Mayo Clinic, Scottsdale, Arizona told Reuters Health.

Previous studies have shown that combining chemotherapy with radiotherapy improves survival over chemotherapy alone for lung cancer. Small-cell lung cancer is a less common form of lung cancer that usually has poorer survival rates.

Schild and colleagues evaluated the effects of age on treatment tolerance, disease control, and survival in 263 patients with limited-stage small-cell lung cancer who participated in a clinical trial. The treatment included the drugs etoposide and cisplatin, which was combined with radiotherapy that was given once or twice daily. In all, 209 patients were younger than 70 years of age and 54 were older.

“In spite of the increase in specific toxicities that accompanied combined-modality therapy in elderly patients,” Schild said, “they had disease control and survival rates similar to those of younger patients.”

At two years, 48 percent of the younger patients and 33 percent of the older patients were still alive. At five years, 22 percent of the younger patients and 17 percent of the older patients were still alive.

Although the overall rates of treatment side effects were similar between the two age groups, severe pneumonitis—marked by breathing difficulty and a severe, dry cough—was seen in 6 percent of the older patients but in none of the younger group.

These findings suggest that elderly patients can receive combination cancer therapy “with the expectation of relatively favorable long-term survival.”

SOURCE: Cancer, April 25, 2005.

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