Elderly lung cancer patients tolerate combined chemotherapy and radiotherapy with no higher risk of death than younger patients, according to a new study appearing in the June 1, 2005 issue of CANCER, a peer-reviewed journal of the American Cancer Society.
Lung cancer remains the leading cause of cancer deaths in the U.S., with half of those diagnosed at age 70 years or older. About 20 percent of patients with lung cancer will have small cell lung cancer (SCLC). In the past, SCLC progressed rapidly despite initial chemotherapy sensitivity and few patients survive three years.
New treatment modalities have provided encouraging results. Studies have found chemotherapy combined with radiotherapy improves survival over chemotherapy alone. Since that finding, researchers have developed new protocols for combined modality treatment to improve survival. Investigators led by Steven E. Schild, M.D. of the Mayo Clinic and the North Central Cancer Treatment Group conducted a clinical trial using two different approaches to combined therapies. Using data from this trial, they sought to evaluate the role of age in therapy tolerance, disease control, and survival following combined modality therapy.
They found that two- and five-year survival rates and disease progression rates were not significantly different for patients younger than 70 compared to those 70 years of age and older. At five years, 22 percent of patients younger than 70 were living compared to 17 percent of elderly patients. This difference is not statistically significant. While overall toxicity was similar between the two age groups, specific moderate and severe toxicities occurred more frequently in the elderly. Severe pneumonitis requiring ventilation or continuous oxygen was significantly more common in the elderly, occurring in 6 percent of elderly patients compared to no patients in the younger age group.
Based on their findings, the authors conclude: "fit elderly patients with locally advanced limited stage small cell lung cancer should be encouraged to receive combined modality therapy, preferably on clinical trials."