Multimodality therapy improves survival in elderly patients with locally advanced non-small cell lung cancer—A retrospective analysis

ObjectivesConcurrent combined modality therapy is optimal treatment for patients with stage III non-small cell lung cancer (NSCLC) and is given with curative intent. However, elderly patients (≥ 75) are often undertreated, despite good performance status (PS). This study evaluated the treatment, outcomes and survival in elderly patients with stage III NSCLC versus patients < 75 years old.Materials and MethodsA retrospective review of data from the Lung Cancer Registry at Mayo Clinic Arizona (MCA) was conducted. Patients with newly diagnosed stage III NSCLC from 1998 to 2006 were analyzed for type of therapy and outcomes.ResultsThree hundred and eighty-nine patients with newly diagnosed stage III NSCLC were identified from 1998 to 2006. Two hundred and forty-three (62%) patients were < 75 years old, and 146 patients (38%) were ≥ 75 years old. Among 374 eligible patients, 45% of patients < 75 years old received combined chemoradiation therapy vs. only 21% of patients ≥ 75 years old (p < 0.0001). The median survival in the < 75 age group was 14.5 months vs. 10.1 months in the ≥ 75 age group (p = 0.0014). In the < 75 age group, median survival was 15.0 months in patients who received combined modality treatment vs. 14.1 months in the other treatments group (p = 0.02). In the elderly group, median survival was 19.9 months in the combined modality group vs. 7.8 months in the other treatments group (p = 0.0048).ConclusionOur results confirm that older patients are less likely to receive optimal therapy, regardless of functional status. Prospective studies are desperately needed to help improve management of the burgeoning geriatric oncology population.