Objective: To investigate whether the clinical characteristics, treatment modalities and prognosis of elderly (>/= 70 years) patients with advanced non-small cell lung cancer (NSCLC) differed from those of young (</= 45 years) patients.
Methods: This retrospective study included 256 elderly patients and 143 young patients with chemotherapy-naive advanced NSCLC treated at Department of Thoracic Medical Oncology in Beijing Cancer Hospital from March 1995 to May 2007. All patients received first-line chemotherapy. Clinical data were analyzed using chi-square test, Log-lank test, Cox regression and Kaplan-Meier survival analysis.
Results: (1) Women, adenocarcinoma and stage IV disease were more common in young patients (46.2% vs 22.3%, P = 0.000, 71.3% vs 54.7%, P = 0.001 and 72.7% vs 61.7%, P = 0.026), when compared with elderly patients. The smoker rate in young women was also higher (95.5%). (2) The disease control rate (DCR) of first-line chemotherapy was similar between young and elderly patients (P = 0.257). Platinum-based combination chemotherapy was a benefit factor for the disease control rate of first-line chemotherapy, whatever in young patients (P = 0.047) or in elderly patients (P = 0.028). Hematologic toxicities were similar between these 2 groups. (3) There was no significant difference in terms of median progression free survival (PFS) or median overall survival (OS) between young and elderly patients (P = 0.399 and P = 0.869, respectively). (4) Easten Cooperative Oncology Group (ECOG) score, DCR for first-line chemotherapy and the regimen of second-line chemotherapy were all independent prognostic factors (P = 0.000, 0.021 and 0.000 in young patients, P = 0.007, 0.000 and 0.000 in elderly patients, respectively).
Conclusion: Women, adenocarcinoma and stage IV disease were more common in young patients when compared with elderly patients. The increased incidence of NSCLC in young women may be associated with the high smoker rate. The OS and PFS were not significantly different between young and elderly patients.