Treatment Outcome for Elderly Patient with Small cell Lung cancer (SCLC)

Shivanshan Pathmanathan, Sophie Conroy, Robert Mason, Jasoth Sanmugarajah, Mohammed F Islam

Introduction:  75% of all newly diagnosed patients with small cell lung SCLC are more than 60 years and 20% more than 75 years old¹. Elderly patients encounter higher chemotherapy related toxicities. They are not well presented in clinical trial³. Only 66% older patients with locally advanced lung cancer receive any form of cancer treatment². In our tertiary hospital we conducted a retrospective study for this age group.

Aim:  The aim of the study is to evaluate chemotherapy related toxicities, progression free survival (PFS) and overall survival (OS) for the elderly  patient with SCLC.

Method: We conducted a retrospective study for the patients with SCLC,  who are at or above 70 years old treated at Gold Coast University Hospital in the last 5 years. Data was collected from medical records.

Result: Total of 41 patients was included. 9 patients with limited stage (LS) treated with chemotherapy and radiotherapy. 32 patients with extensive stage (ES) treated with chemotherapy only. 75% patients completed first line treatment. 58% patients needed with dose reduction with the first cycle. 30% patients had grad 3 to 4 toxicity. 73% patients suffered from neutropenia. 17% patients had febrile neutropenia, 24% had thrombocytopenia and 24 % suffered from fatigue. Median PFS for LS 204 days and median OS 355 days. Median PFS for ES 155 days and OS 310 days.  8 patients are still alive and 3 were lost from follow up.

Conclusion: Elderly patient can be treated with standard doublet chemotherapy. Significant number of patients needed dose reduction. In spite of this toxicities and hospital admissions are higher. Comprehensive geriatric assessment might help to identify vulnerable patients.

Reference:

1.  Crit Rev Oncol Hematol 2007;62:172-178

2. J Thorac Oncology6;934-941,2011

3. N Eng J Med 1999;341:2061-2067