{'fraction_non_alphanumeric': 0.022459292532285232, 'fraction_numerical': 0.008422234699606962, 'mean_word_length': 5.433212996389892, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Vinorelbine in elderly patients with inoperable nonsmall cell lung carcinoma

We read with great interest the study of Drs. Buccheri and Ferrigno regarding the use of vinorelbine in the treatment of elderly patients with inoperable nonsmall cell lung carcinoma (NSCLC). The authors reported that in their group of patients who had poor prognoses, vinorelbine was found to be well tolerated, moderately active, and capable of ensuring relatively long survival. They did not observe any toxic deaths. We planned to use the combination of vinorelbine and carboplatin in the treatment of a 68-year-old patient with inoperable NSCLC (T3N1M0). After the first administration of the drug combination, myelosuppression and paralytic ileus developed. Because the patient’s clinical picture of ileus did not respond to medical treatment, he underwent emergency surgical intervention at a very critical stage (with a granulocyte count of 600/mm and a platelet count of 10,000/mm). The patient died of respiratory insufficiency in the postoperative period. We agree with the authors that vinorelbine may represent a valuable therapeutic option in elderly patients with inoperable NSCLC. In many previous studies, gastrointestinal toxicities were reported to be mild to moderate nausea and emesis, constipation, paralytic ileus, diarrhea, anorexia, and transient alterations in liver enzymes. The reported overall incidence of paralytic ileus was aproximately 1%. 4 However, this rate may be higher in an elderly patient population in whom gastrointestinal motility already has been impaired. For this reason, we suggest that when vinorelbine therapy is planned in elderly patients, intestinal motility should be monitored closely and necessary precautions should be administered without delay.