In a nutshell
This study looked at whether chemotherapy following surgery could improve survival in elderly patients with non-small cell lung cancer.
Some background
Adjuvant chemotherapy refers to chemotherapy is given after a primary treatment, such as surgery. The effectiveness of this has not been well established in elderly patients with tumors that are 4 cm or larger.
This is due to the fact that many cancer studies are performed on young people in relatively good health. This means that many of these studies may not be applicable to the elderly.
Methods & findings
3289 patients were included in this study. All patients had stage 1 lung cancer with tumors 4 cm or bigger. The majority of the patients (84%) underwent surgery alone. Others received chemotherapy or radiotherapy after surgery. Patients were followed for an average of 54 months.
Those given adjuvant chemotherapy were found to be younger. Some factors prevented patients receiving this treatment. These included complications and long hospital stays following surgery.
Those who received adjuvant chemotherapy were 18% more likely to survive for the duration of the trial.
When compared with surgery, patients receiving radiotherapy were 91% less likely to survive for the length of the study.
Patients who received radiotherapy after surgery also had the most side effects following treatment. These patients were 3.8 times as likely to suffer a serious side effect.
Adjuvant chemotherapy led to 2.6 times the risk of hospitalization for low white blood cells and 4.4 times the risk for dehydration compared to surgery alone.
After 6 months, 96% of patients who recieved adjuvant chemotherapy were still alive. In comparison, 92.5% of patients who only received surgery were still alive.
The bottom line
This study concluded that adjuvant chemotherapy is linked with better survival rates for patients aged 65 and older. This study also concluded that adjuvant chemotherapy was also linked with an increased risk of adverse events requiring hospitalization.
The fine print
Patients were not randomly assigned treatments. Future studies should randomly assign them.
What’s next?
Discuss the benefits of adjuvant chemotherapy for treating NSCLC with your doctor.
Published By :
Annals of oncology
Date :
Jan 18, 2015