Treatment and survival of patients with small-cell lung cancer: small steps forward, but not for patients >80
Menée aux Pays-Bas auprès de 13 007 participants âgés de plus de 60 ans, cette étude évalue l’évolution des traitements et la survie de patients atteints de cancer du poumon à petites cellules
Background: Seventy-five percent of newly diagnosed patients with small-cell lung cancer (SCLC) are aged 60+ and quite a few are treated less aggressively because of fear of toxic effects. We described trends in treatment and survival of unselected SCLC patients.Patients and methods: For the present study, all 13 007 SCLC patients aged 60+ diagnosed in The Netherlands from 1997 to 2007 were included.Results: Among patients with limited disease, the proportion receiving chemoradiation increased from 35% to almost 60% for those aged 60–69, from 28% to 48% in age group 70–74, from 17% to 33% in age group 75–79, but remained <10% for those aged 80+. Among patients with extensive disease, the proportion receiving chemotherapy (CT) decreased from 81% of patients aged 60–64 to 23% of those aged 85+, without substantial changes over time. Survival has only improved for patients <80 years.Conclusions: CT (+radiotherapy) has improved survival for unselected SCLC patients <80. A better understanding of the impact of frailty on completion of treatment and toxic effects among patients aged 80+ would enable the treating physician to anticipate toxic effects better and to discuss risks and benefits of treatment with the patient.
Annals of Oncology 2011