Chemotherapy after surgery for elderly patients with non–small cell lung cancer

This analysis examined the use of adjuvant chemotherapy in elderly patients with non–small cell lung cancer (NSCLC). Chemotherapy treatments and their effect on survival were compared between patients in different age groups. 

Adjuvant chemotherapy (chemotherapy treatment given after cancer surgery) has been proven to benefit survival in patients with spreading NSCLC. However, in former studies showing the benefit of adjuvant chemotherapy, patients over 70 years old composed only a small part of the examined population. This analysis specifically examined the benefit of adjuvant chemotherapy in elderly patients. 

The medical records of 6,304 patients with NSCLC, treated with surgery in Ontario, Canada, were used in this analysis. 2,763 (43.8%) of the patients were over 70 years old.

The use of adjuvant chemotherapy in the elderly increased from 3.3% (in 2001 to 2003) to 16.2% (in 2004 to 2006). In comparison, the use of adjuvant chemotherapy in younger patients was 42.7% (in 2004 to 2006). In order to deduce the benefit of adjuvant chemotherapy, the survival of elderly patients diagnosed in these two time periods was compared.

4 years after treatment, 47.1% of patients diagnosed from 2001 to 2003 survived. For patients diagnosed from 2004 to 2006 the 4-year survival rate was 49.9%. This increase in survival was seen in all age subgroups except in patients above the age of 80.

Adjuvant chemotherapy was associated with a similar rate of adverse events in young and elderly patients alike.

This study concluded that adjuvant chemotherapy in the treatment of elderly patients with NSCLC is associated with a survival benefit and similar rates of adverse events to those found in younger patients.

Since this study blankly compared survival rates to diagnosis periods, other changes in medical standards occurring during these time periods probably influenced results to some degree. For instance, changes in radiotherapy treatments or early diagnosis methods were not accounted for.