According to results presented at the 2006 annual meeting of the American Society of Clinical Oncology (ASCO), adjuvant chemotherapy improves the survival of elderly patients with stage IB or stage II non-small cell lung cancer (NSCLC). Compared to younger patients, however, older patients were more likely to refuse chemotherapy and less likely to complete chemotherapy.
Lung cancer remains the leading cause of cancer death in the U.S. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for 75%–80% of all lung cancers.
Recent studies have demonstrated that among patients who have undergone surgical removal of NSCLC, adjuvant chemotherapy improves survival. It remains uncertain, however, whether this survival benefit applies to both younger and older patients, and whether older patients are able to tolerate chemotherapy.
To explore the use and outcome of adjuvant chemotherapy among patients with stage IB or stage II NSCLC, researchers in Canada conducted a study among 327 patients under the age of 65 and 155 patients over the age of 65.
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- Among patients over the age of 65, adjuvant chemotherapy significantly improved survival (risk of death was reduced by 39%).
- Survival among patients over the age of 65 was not significantly different than survival among patients under the age of 65 (although the subset of patients over the age of 75 did have worse outcomes).
- The toxic effects of chemotherapy were similar in older and younger patients.
- Compared to younger patients, patients over the age of 65 were less likely to complete chemotherapy and more likely to refuse chemotherapy.
The researchers conclude that in spite of receiving less chemotherapy than younger patients, NSCLC patients over the age of 65 derive a survival benefit from adjuvant chemotherapy. The researchers note that use of chemotherapy in patients over the age of 75 requires further study.
Reference: Pepe C, Hasan B, Winton T et al. Adjuvant Chemotherapy in Elderly Patients: An Analysis of National Cancer Institute of Canada Clinical Trials Group and Intergroup BR.10. Presented at the 2006 ASCO Annual Meeting. Abstract 7009.
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