Radiotherapy for non-small cell lung cancer in patients aged 75 and over: safety, effectiveness and possible impact on survival

Lonardi, Federico; Coeli, Manuela; Pavanato, G.; Adami, F.; Gioga, Gloria; Campostrini, Franco

doi:10.1016/s0169-5002(99)00117-8

Cited by 33 publications

(18 citation statements)

References 26 publications

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“…They concluded that palliative radiotherapy was well tolerated and the response was similar to that in younger patients. Other studies have also indicated that (radical) radiotherapy can be applied to elderly people without increased toxicity [20][21][22][23]. However, heterogeneity among individuals increases with increasing age, and more than in younger cancer patients, all therapeutic options should be considered in relation with careful evaluation of the patient (functional assessment, comorbidities, stage of disease, social situation, individual wishes for therapy, etc.)…”

Section: Discussionmentioning

confidence: 99%

Influence of age, comorbidity and performance status on the choice of treatment for patients with non-small cell lung cancer; results of a population-based study

et al. 2004

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SummaryBackground: In the Netherlands in 1997, 43% of patients with newly diagnosed lung cancer were over 70. Large age-specific differences in treatment exist. We examined whether age, comorbidity, performance status and pulmonary function influenced treatment. Patients and methods: Data on patients with newly diagnosed non-small cell lung cancer (N = 803) were obtained: comorbidity, performance status, pulmonary function (FEV1) and initial treatment. Age-specific differences in treatment according to the guidelines were examined. Odds ratios were calculated by means of logistic regression analyses. Results: 82% with stage I or II disease received treatment according to the guidelines; this applied to 48% with stage IIIA disease and to 54% with stage IIIB disease. For all stages, this proportion decreased with increasing age. In stage IV disease, 36% did not receive any treatment; this applied to 52% of the elderly patients (75 + years). Multivariate analyses showed associations between comorbidity and treatment choice, but none with performance status. Age of 75 + years appeared to be the most important factor for not receiving treatment according to guidelines. Conclusion:A substantial proportion of elderly patients with non-small cell lung cancer did not receive standard treatment. Performance status and comorbidity seldom formed the underlying reason. Calendar rather than biological age seemed to play the most important role in choice of treatment for patients with non-small cell lung cancer.

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Section: Discussionmentioning

confidence: 99%

Influence of age, comorbidity and performance status on the choice of treatment for patients with non-small cell lung cancer; results of a population-based study

et al. 2004

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“…Although both curative and palliative treatments can be offered to them, quality of life and emotional needs are to be respected whatever the therapeutic choice may be. Radical treatments may offer some survival gains and should not be denied on the basis of age alone [19], yet the majority of older patients with advanced solid cancers are unfit for aggressive approaches. They are likely to achieve clinical benefit only from tailored palliative treatments, in which RT often plays the leading role.…”

Section: Discussionmentioning

confidence: 99%

Double-flash, large-fraction radiation therapy as palliative treatment of malignant superior vena cava syndrome in the elderly

Lonardi¹,

Gioga²,

Agus³

et al. 2002

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Rapid control of symptoms is mandatory in cancer-induced superior vena cava syndrome (SVCS), but older patients often do not tolerate aggressive approaches. In order to maximize symptom relief and minimize treatment-related discomfort of aged patients in poor health we adopted a short-course, large-fraction radiation therapy (RT) schedule. Twenty-three consecutive patients aged over 70 who were suffering from solid-malignancy-related SVCS were enrolled. A total dose of 12 Gy was given in two 6-Gy fractions, 1 week apart, mainly in an out-patient setting. Completion of therapy to give up to 37-40 Gy was planned in the best-responding patients. Symptom relief was experienced by 8 patients as early as 4-5 days after the first fraction. The overall response rate was 87%. Despite some mild systemic side effects (chest pain, fever) reported by 5 patients (22%), overall toxicity was negligible. Short-course, double-flash RT stands as an effective and safe tool in the palliative treatment of malignant SVCS in older patients. Fractions larger than 6 Gy can be avoided in order to minimize side and toxic effects.

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“…Lonardi et al [21] reported on a group of patients ≥75 years for safety, effectiveness, and possible impact on survival with radiotherapy at a dose of 50 Gy. The patients did not develop grade 3/4 esophagitis, nausea, vomiting, dermatitis, or leukopenia.…”

Section: Advanced-stage Nsclcmentioning

confidence: 99%

Non-Small Cell Lung Cancer in the Elderly

2004

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The population is aging both in developing and developed countries. What is clear is that currently over 50% of all patients with non-small cell lung cancer (NSCLC) are 65 years of age or older. When deciding a treatment strategy, the biological rather than the chronological age should be carefully assessed, and treatment should only be modified or withheld for very good reason. This applies equally to surgery, radiation therapy, and chemotherapy. Fortunately, recently published studies have focused on the issue and have provided strong evidence of improved progression-free survival, overall survival, and quality of life in elderly patients with appropriately treated NSCLC. The

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Radiotherapy for non-small cell lung cancer in patients aged 75 and over: safety, effectiveness and possible impact on survival

Cited by 33 publications

References 26 publications

Influence of age, comorbidity and performance status on the choice of treatment for patients with non-small cell lung cancer; results of a population-based study

Influence of age, comorbidity and performance status on the choice of treatment for patients with non-small cell lung cancer; results of a population-based study

Double-flash, large-fraction radiation therapy as palliative treatment of malignant superior vena cava syndrome in the elderly

Non-Small Cell Lung Cancer in the Elderly

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