Radiotherapy as the primary and palliative treatment for 75 years and older patients with locally advanced and metastatic non-small cell lung cancer: Analysis of 45 cases with a review of the literature
Kaytan Saglamer, Esra
Oral, Ethem Nezih
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Aim: To evaluate the prognostic factors and treatment results of 75 years or older Turkish patients with locally advanced and metastatic non-small cell lung cancer (NSCLC). Patients and Methods: Forty-five patients ≥ 75 years were evaluated. Median age was 78 (75-93). Thirty-four patients (75%) had stage IIIB and 11 patients had stage IV disease (25%). Fourteen patients (41%) with stage IIIB disease were treated with curative radiotherapy (RT), 18 patients (52%) with palliative RT and 2 patients (5%) were treated with only chemotherapy (CT). Results: One-year survival rate was 37%. Overall median survival was 12.7 months in stage IIIB and 7.67 months in stage IV. In univariate analysis, advanced stage (p=0.0006), performance status (p=0.056), absence of radiotherapy (p=0.0008) and weight loss (p=0.0053) adversely affected the survival. In multivariate analysis only stage IV was found to be statistically significant independent poor prognostic factor (p=0.0025 HR=0.2760 (0.12-0.60) 95% confidence interval). Conclusion: In 75 years and older Turkish patients with NSCLC, stage IV disease was associated with poor prognosis. The higher radiotherapy doses did not improve survival in patients with stage IIIB disease and the prognosis with only radiotherapy is similar to the results of chemoradiation in the literature in this age group.