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Time and chemotherapy treatments trends in the elderly (age>70) with lung cancer in a single UK cancer centre.

7128 Background: There are few data on the outcome in elderly populations (> 70) with lung cancer over the past 20 years. Equally there is little known about long term outcomes when treated with chemotherapy. This study focuses on elderly lung cancer patients (age>70) in a single UK cancer centre over the past 20 years.


METHODS
We retrospectively reviewed 960 patients who received treatment for lung cancer (NSCLC, SCLC and mesothelioma) in Royal Marsden Hospital (RMH) between 1982 and 2003. Patient characteristics, type of tumors, stage, performance status (PS), year of presentation, treatment and cause of death were analyzed. Survival analysis was done by the Kaplan Meier method. Comparison of all cause survival was done between patients presenting in 1982-1994 and 1995-2003 by the log rank test. Comparison of survival between different treatment regime used the proportional hazards model.


RESULTS
There has been an improvement in all cause survival (adjusted for sex, stage and PS) in all age groups. Between 1982 and 2003, there were 960 elderly patients with 519 aged 70-74, 328 aged 75-79 and 113 were aged ≥ 80 treated in the RMH. Of these, 55% of patients had NSCLC, 38% SCLC and 7% patients had mesothelioma which was either locally advanced or metastatic. Over 85% patients were had performance status 0-2. In early cohort, there were 270 patients and 690 patients in the recent cohort. The later group of patients has better survival and the difference is more pronounced in patients >80( p<0.001). As treatment, 41% patients received cisplatin combination, 18% carboplatin combination, 4% non-platinum combination, 17% single agent treatment and 30% no chemotherapy. Carboplatin combinations were significantly better than others after adjusting for PS, stage and sex(p =0.007) in all 3 groups of elderly patients. Cisplatin combinations were found to do marginally better (p=0.06).


CONCLUSIONS
This analysis demonstrated that there has been a significant improvement in survival for elderly patients with lung cancer in the past 20 years. Carboplatin combination seems to have greater impact on survival than other combinations and single agent treatment. No significant financial relationships to disclose.