Small-cell Lung Cancer in Very Elderly (≥ 80 Years) Patients
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. One hundred forty-six very elderly patients with SCLC were identified from the Institutional Lung Cancer Database rangi...
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| Veröffentlicht in: | Clinical lung cancer 2019-07, Vol.20 (4), p.313-321 |
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| creator | Schild, Steven E. Zhao, Liming Wampfler, Jason A. Daniels, Thomas B. Sio, Terence Ross, Helen J. Paripati, Harshita Marks, Randolph S. Yi, Joanne Liu, Han He, Yanqi Yang, Ping |
| description | 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.
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.
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 |
| doi_str_mv | 10.1016/j.cllc.2019.05.007 |
| format | Article |
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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.
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.
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.
This study found that the survival of very elderly (≥ 80 years) patients with small-cell lung cancer was associated with stage, performance status, and treatment option. Very elderly patients with small-cell lung cancer are a growing patient population who have not been previously reported on. Future progress will require trials specific to the elderly, integration of immunotherapy, greater supportive care, better geriatric assessment, and less toxic regimens.</description><identifier>ISSN: 1525-7304</identifier><identifier>EISSN: 1938-0690</identifier><identifier>DOI: 10.1016/j.cllc.2019.05.007</identifier><identifier>PMID: 31155475</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Chemoradiotherapy ; Chemotherapy ; China - epidemiology ; Cohort Studies ; Female ; Humans ; Lung Neoplasms - epidemiology ; Lung Neoplasms - mortality ; Lung Neoplasms - therapy ; Male ; Neoplasm Staging ; Pneumonectomy ; Radiation therapy ; Radiotherapy ; Resection ; Small Cell Lung Carcinoma - epidemiology ; Small Cell Lung Carcinoma - mortality ; Small Cell Lung Carcinoma - therapy ; Surgery ; Survival Analysis ; Treatment ; Treatment Outcome</subject><ispartof>Clinical lung cancer, 2019-07, Vol.20 (4), p.313-321</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-5b159351f2d4e04bf4a0aa5fcc3d6ff9182c1e6438be3c48e08304d359cc76ec3</citedby><cites>FETCH-LOGICAL-c356t-5b159351f2d4e04bf4a0aa5fcc3d6ff9182c1e6438be3c48e08304d359cc76ec3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.cllc.2019.05.007$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27911,27912,45982</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31155475$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schild, Steven E.</creatorcontrib><creatorcontrib>Zhao, Liming</creatorcontrib><creatorcontrib>Wampfler, Jason A.</creatorcontrib><creatorcontrib>Daniels, Thomas B.</creatorcontrib><creatorcontrib>Sio, Terence</creatorcontrib><creatorcontrib>Ross, Helen J.</creatorcontrib><creatorcontrib>Paripati, Harshita</creatorcontrib><creatorcontrib>Marks, Randolph S.</creatorcontrib><creatorcontrib>Yi, Joanne</creatorcontrib><creatorcontrib>Liu, Han</creatorcontrib><creatorcontrib>He, Yanqi</creatorcontrib><creatorcontrib>Yang, Ping</creatorcontrib><title>Small-cell Lung Cancer in Very Elderly (≥ 80 Years) Patients</title><title>Clinical lung cancer</title><addtitle>Clin Lung Cancer</addtitle><description>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.
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.
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.
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.
This study found that the survival of very elderly (≥ 80 years) patients with small-cell lung cancer was associated with stage, performance status, and treatment option. Very elderly patients with small-cell lung cancer are a growing patient population who have not been previously reported on. Future progress will require trials specific to the elderly, integration of immunotherapy, greater supportive care, better geriatric assessment, and less toxic regimens.</description><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Chemoradiotherapy</subject><subject>Chemotherapy</subject><subject>China - epidemiology</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Lung Neoplasms - epidemiology</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - therapy</subject><subject>Male</subject><subject>Neoplasm Staging</subject><subject>Pneumonectomy</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Resection</subject><subject>Small Cell Lung Carcinoma - epidemiology</subject><subject>Small Cell Lung Carcinoma - mortality</subject><subject>Small Cell Lung Carcinoma - therapy</subject><subject>Surgery</subject><subject>Survival Analysis</subject><subject>Treatment</subject><subject>Treatment Outcome</subject><issn>1525-7304</issn><issn>1938-0690</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtKA0EQhhtRTIxewIX0Mi5mrH5NekAECfEBAQUf4Krp9NTIhM4kds8IOYIH8WKexAlRl66qFt__U_URcswgZcCys3nqvHcpB5anoFKA0Q7ps1zoBLIcdrtdcZWMBMgeOYhxDsAzwfg-6QnGlJIj1ScXDwvrfeLQezpt61c6trXDQKuaPmNY04kvMPg1HX59fFIN9AVtiKf03jYV1k08JHul9RGPfuaAPF1NHsc3yfTu-nZ8OU2cUFmTqBlTuVCs5IVEkLNSWrBWlc6JIivLnGnuGGZS6BkKJzWC7q4uhMqdG2XoxIAMt72rsHxrMTZmUcXN0bbGZRsN50JKneVadyjfoi4sYwxYmlWoFjasDQOz8WbmZuPNbLwZUKbz1oVOfvrb2QKLv8ivqA443wLYffleYTDRdQYcFlVA15hiWf3X_w2OeH0U</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Schild, Steven E.</creator><creator>Zhao, Liming</creator><creator>Wampfler, Jason A.</creator><creator>Daniels, Thomas B.</creator><creator>Sio, Terence</creator><creator>Ross, Helen J.</creator><creator>Paripati, Harshita</creator><creator>Marks, Randolph S.</creator><creator>Yi, Joanne</creator><creator>Liu, Han</creator><creator>He, Yanqi</creator><creator>Yang, Ping</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201907</creationdate><title>Small-cell Lung Cancer in Very Elderly (≥ 80 Years) Patients</title><author>Schild, Steven E. ; Zhao, Liming ; Wampfler, Jason A. ; Daniels, Thomas B. ; Sio, Terence ; Ross, Helen J. ; Paripati, Harshita ; Marks, Randolph S. ; Yi, Joanne ; Liu, Han ; He, Yanqi ; Yang, Ping</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-5b159351f2d4e04bf4a0aa5fcc3d6ff9182c1e6438be3c48e08304d359cc76ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Chemoradiotherapy</topic><topic>Chemotherapy</topic><topic>China - epidemiology</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Lung Neoplasms - epidemiology</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - therapy</topic><topic>Male</topic><topic>Neoplasm Staging</topic><topic>Pneumonectomy</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Resection</topic><topic>Small Cell Lung Carcinoma - epidemiology</topic><topic>Small Cell Lung Carcinoma - mortality</topic><topic>Small Cell Lung Carcinoma - therapy</topic><topic>Surgery</topic><topic>Survival Analysis</topic><topic>Treatment</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schild, Steven E.</creatorcontrib><creatorcontrib>Zhao, Liming</creatorcontrib><creatorcontrib>Wampfler, Jason A.</creatorcontrib><creatorcontrib>Daniels, Thomas B.</creatorcontrib><creatorcontrib>Sio, Terence</creatorcontrib><creatorcontrib>Ross, Helen J.</creatorcontrib><creatorcontrib>Paripati, Harshita</creatorcontrib><creatorcontrib>Marks, Randolph S.</creatorcontrib><creatorcontrib>Yi, Joanne</creatorcontrib><creatorcontrib>Liu, Han</creatorcontrib><creatorcontrib>He, Yanqi</creatorcontrib><creatorcontrib>Yang, Ping</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical lung cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schild, Steven E.</au><au>Zhao, Liming</au><au>Wampfler, Jason A.</au><au>Daniels, Thomas B.</au><au>Sio, Terence</au><au>Ross, Helen J.</au><au>Paripati, Harshita</au><au>Marks, Randolph S.</au><au>Yi, Joanne</au><au>Liu, Han</au><au>He, Yanqi</au><au>Yang, Ping</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Small-cell Lung Cancer in Very Elderly (≥ 80 Years) Patients</atitle><jtitle>Clinical lung cancer</jtitle><addtitle>Clin Lung Cancer</addtitle><date>2019-07</date><risdate>2019</risdate><volume>20</volume><issue>4</issue><spage>313</spage><epage>321</epage><pages>313-321</pages><issn>1525-7304</issn><eissn>1938-0690</eissn><abstract>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.
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.
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.
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.
This study found that the survival of very elderly (≥ 80 years) patients with small-cell lung cancer was associated with stage, performance status, and treatment option. Very elderly patients with small-cell lung cancer are a growing patient population who have not been previously reported on. Future progress will require trials specific to the elderly, integration of immunotherapy, greater supportive care, better geriatric assessment, and less toxic regimens.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31155475</pmid><doi>10.1016/j.cllc.2019.05.007</doi><tpages>9</tpages></addata></record> |
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| subjects | Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Chemoradiotherapy Chemotherapy China - epidemiology Cohort Studies Female Humans Lung Neoplasms - epidemiology Lung Neoplasms - mortality Lung Neoplasms - therapy Male Neoplasm Staging Pneumonectomy Radiation therapy Radiotherapy Resection Small Cell Lung Carcinoma - epidemiology Small Cell Lung Carcinoma - mortality Small Cell Lung Carcinoma - therapy Surgery Survival Analysis Treatment Treatment Outcome |
| title | Small-cell Lung Cancer in Very Elderly (≥ 80 Years) Patients |
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