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G.N. Hillerdal



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    P1.06 - Poster Session with Presenters Present (ID 458)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P1.06-008 - Non-Small Cell Lung Cancer in Octogenarians: Real-Life Clinical Practice; Characteristics, Therapy and Survival (ID 4034)

      14:30 - 15:45  |  Author(s): G.N. Hillerdal

      • Abstract

      Background:
      Globally, more people are surviving to older age; consequently, an increasing proportion of cancer patients are aged >65 years and many are aged >70 years. Treatment of the elderly with lung cancer has, therefore, become an important issue. We performed a retrospective study of our patients to demonstrate how octogenarians with non-small cell lung cancer (NSCLC) are treated in real-life clinical practice.

      Methods:
      A retrospective observational study of all elderly (>80 years) patients with NSCLC referred to Department of Respiratory Medicine and Allergy, Karolinska Hospital, Sweden, 2003-2010 and followed until June, 2016.

      Results:
      During the period 2662 patients were newly diagnosed with lung cancer. 485 (12.2%) were 80 years or older. 33 (6.8%) hade small cell lung cancer and were excluded, leaving 452 for the study. 216 (47.8%) were male. Mean, median, and range age for males were 83.8, 83, and 80-96 years, respectively. These figures for females were 83.7, 83, and 86-95. 28 (6.2%) of the population were 90 years old or older. 77.8% patients were current or former smokers with significant differences between the genders (p<0.001). There was no difference in performance status (PS) between the genders (p<0.93), with PS 0-1 in 45%, PS2 in 26% and PS3-4 in 29%. 33.9% of patients were diagnosed in stages 1-II, 34.1% in stage III and 31.9% in stage IV. Most of the patients, 45.6%, had adenocarcinoma, 18.1% squamous cell carcinoma, while histological diagnosis was unavailable in 23.2%. There were significant differences in treatment modalities (p=0.040). Chemotherapy was given in 9.5%, local radiotherapy in 17%, stereotactic body radiotherapy (SBRT) in 10.6%, 6.9% underwent surgery and 209 (46.2%) were not given any therapy. Second-line chemotherapy was given in 4% and third-line in 1.5%. Only one patient received fourth line. Median overall survival was 115 days in patients given no therapy and 362 days in patients given any therapy. Patients who underwent surgery had a median overall survival of 5,6 years compared to 3,5 years for patients given SBRT (p=0.0187). There were no significant differences in survival between genders.

      Conclusion:
      Treatment of NSCLC patients 80 years and older with any modality is feasible with a good PS. Survival is fairly good with surgery or SBRT.

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    P2.03a - Poster Session with Presenters Present (ID 464)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Advanced NSCLC
    • Presentations: 1
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      P2.03a-013 - Chemotherapy is Beneficial for Octogenarians with Non-Small Cell Lung Cancer (NSCLC) (ID 4354)

      14:30 - 15:45  |  Author(s): G.N. Hillerdal

      • Abstract

      Background:
      In Sweden, almost half of the patients diagnosed with lung cancer diagnosis are more than 70 years old and indeed14% were 80 years and older. Treatment of the elderly with lung cancer has, therefore, become an important issue. In the Stockholm county, almost all patients with lung cancer are preferred to Karolinska University Hospital. We performed a retrospective study of our patients to demonstrate how octogenarians with non-small cell lung cancer (NSCLC) treated with chemotherapy responded in real-life clinical practice

      Methods:
      A retrospective observational study of all elderly (>80 years) patients with NSCLC referred to Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Sweden, 2003-2010 and followed until June, 2016

      Results:
      In total, 2350 patients were newly diagnosed with lung cancer during this period. 453 (19.2%) were 80 years or older and had NSCLC. Of these 51(11 %) received chemotherapy. In that group, mean and median age was 82 years (range 80-89). 86% were current- och ex-smokers. 70% had PS 0-1, 27% PS 2, and 2% PS 3. 92% had stage III-IV. Adenocarcinoma was the most prevalent histology type (59%) and squamous cell carcinoma was second (24%). 61% received carboplatin/gemcitabine, 8% carboplatin/vinorelbine, 12% gemcitabine only, and 16% vinorelbine only. Most patients (47%) received at least four cycles and another 6% three cycles. Chemotherapy dose reduction/ termination occurred in 12% due to hematologic toxicity, in 18% to non-hematologic toxicities, and in 4% because of progressive disease. In total, therefore, 53% completed their treatment. 59% hade stable disease, 33% partial response, and 9% progressive disease. 22% received second line, 10% third line, but only one patient (2%) 4[th] line treatment. The median overall survival was 281days in male patients and 332 days in females (NS).

      Conclusion:
      Treatment of elderly NSCLC patients with good PS with chemotherapy is feasible and appears to prolong survival.