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Mihai Vasile Marinca



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    P1.12 - Small Cell Lung Cancer/NET (Not CME Accredited Session) (ID 944)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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      P1.12-16 - Management of Elderly Small-Cell Lung Cancer Patients in a Romanian Tertiary Care Center (ID 14397)

      16:45 - 18:00  |  Author(s): Mihai Vasile Marinca

      • Abstract
      • Slides

      Background

      Small cell lung cancer (SCLC) remains one of the most challenging conditions due to its poor prognosis and lack of effective treatments. Although guidelines recommend aggressive treatment in elderly SCLC patients with good performance status, real-life data indicates that this patient subgroup is still undertreated. The aim of this analysis was to assess survival and management in elderly SCLC patients from North-East Romania.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      We performed a retrospective analysis of all elderly patients diagnosed with SCLC and treated in the Regional Institute of Oncology Iasi (a territorial unit responsible for the diagnosis and treatment of cancer patients in Moldova) between 2012 and 2016. For each patient, we collected several types of data regarding patient status, tumor stage and management options that were correlated with overall survival.

      4c3880bb027f159e801041b1021e88e8 Result

      We identified 41 patients diagnosed with SCLC and over 65 years old at the time of diagnosis. Average age was 69.63±3.98, with a median of 69 and a maximum of 78 years. The male to female ratio was 5.83:1, all patients were current or former smokers and performance status was 1 in 76.2% of cases. Most patients (57.1%) were diagnosed in stage IV and received doublet platinum-based systemic treatment in the first line setting. In the subgroup diagnosed with stage III disease, none of the patients received concurrent chemo-radiotherapy and less than half (35.29%) received sequential treatment. Although assessment after first-line treatment was available for less than half of the cases (39.02%), only one patient had progressive disease at that time-point (most were characterized as having a partial response). However, prophylactic cranial irradiation was performed in only 7.31% of cases. Second-line systemic treatment was initiated in 24.39% of cases – the preferred regimen was the CAV protocol followed by oral Topotecan. Overall survival was 11.17 months, with a maximum of 50 months and with statistically significant differences depending on stage and performance status. Age did not influence survival.

      8eea62084ca7e541d918e823422bd82e Conclusion

      Although elderly patients represent an important segment of the individuals affected by SCLC, they are sometimes undertreated and less aggressive management still seems to be the preferred approach despite good performance status and frequent response to first-line therapy. Most likely due to their age or because they delay seeking medical attention, elderly SCLC patients are more often diagnosed in metastatic stages. Our data for Romanian patients is mainly in accordance with available literature, although we found lower overall survival rates.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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