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Yoichiro Hamamoto
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P3.01 - Advanced NSCLC (Not CME Accredited Session) (ID 967)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.01-40 - Treatment of Super Elderly Patients for Non-Small Cell Lung Cancer in Japan (ID 13053)
12:00 - 13:30 | Author(s): Yoichiro Hamamoto
- Abstract
Background
Japan is the one of the country with the longest life expectancy in the world; many elderly Japanese are treated for lung cancer. The number of people dying from lung cancer is consistently increasing, and nearly half of lung cancer patients are older than 75 years of age. It is said that 60% patients died of the lung cancer are patients over 75 years. Approximately half of lung cancers are found in advanced stage, and are treated by chemotherapy. However, many clinical trials of lung cancer treatment using conventional anticancer drugs are targeted toward patients younger than 70years old. No clear evidence on treatment for elderly patients over 80 years has been established.
We conducted a retrospective analysis of patients over 80 years old who were diagnosed with advanced non small cell lung cancer.
a9ded1e5ce5d75814730bb4caaf49419 Method
We retrospectively reviewed the outcome of patients over 80 years old who were diagnosed with advanced non small cell lung cancer between 2012 to 2016.
4c3880bb027f159e801041b1021e88e8 Result
48 patients were incorporated in the study; 26 were treated by chemotherapy (Median age 84years (80-89), 16 males), 22 were in BSC (Median age 84 years (80-96years), 13 males). 69%(18/26) of the treatment group were in Performance Status 0-1, compared to 18%(4/22) in the BSC group.(p=0.0005)
Adenocarcinoma was the most common type in the treatment group(16/28), followed by Squamous cell carcinoma (7/28). Half of the treated patients were in stage Ⅳ, 6 cases were stageⅢb, and 6 cases stageⅢa.
The median overall survival in treatment group was 378 days, median number of regimen conduced was 1 (average 1.37). In BSC group, it was difficult to follow until death, therefore comparison with the treatment group is not analyzed.
8eea62084ca7e541d918e823422bd82e Conclusion
It was suggested that the prognosis was prolonged by chemotherapy in the treatment group, compared to the previous chemotherapy trials for elderly patients. Chemotherapy should also be considered in super elderly patients over 80 years old, when he/she has good PS. However, regarding chemotherapy for the elderly patients with non small cell lung cancer, it is important to carefully consider adverse events.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P3.15 - Treatment in the Real World - Support, Survivorship, Systems Research (Not CME Accredited Session) (ID 981)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/26/2018, 12:00 - 13:30, Exhibit Hall
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P3.15-15 - ALI Could Be a One of Prognostic Survival Factor for Non-Small Cell Lung Cancer Patients (ID 11777)
12:00 - 13:30 | Presenting Author(s): Yoichiro Hamamoto
- Abstract
Background
Patients with terminal non-small cell lung cancer become greatly concerned about where they will die. And the Advanced Lung Cancer Inflammation Index (ALI, body mass index × albumin/neutrophil-to-lymphocyte ratio) has been demonstrated to be a prognostic factor of survival in some solid cancers. We examined the survival times of such patients according to their place of death; i.e., whether they died at home, at a hospice, or at hospital and analysis with ALI.
a9ded1e5ce5d75814730bb4caaf49419 Method
A retrospective cohort study of patients who were followed from their first chemotherapy session for non-small cell lung cancer until death was performed. Specifically, the study compared four groups, those that died at home, at a hospice, at hospital or alive. The study was based on mortality data from the single institute National Hospital in Japan, for the period between April 2010 and December 2015.
4c3880bb027f159e801041b1021e88e8 Result
Among the 313 patients recruited, 214 were analyzed in this study: 90, 49, and 75 received hospital-based, home-based, and hospice-based palliative care, respectively. The patients who died at a hospice exhibited significantly longer survival than those that died at hospital (estimated median survival time, 420 days [95% confidence interval (CI), 325-612 days] vs. 252 days [95% CI, 201-316 days]; P<0.0001), and the patients that died at home also demonstrated significantly longer survival than those that died at hospital (estimated median survival time, 420 days [95% CI, 325-612 days] vs. 341 days [95% CI, 293-460 days]; P<0.0001). No significant difference in survival was detected between the patients that died at home and those that died at a hospice.
At the time of data cut-off, ALI before chemotherapy in 4 groups was evaluated. There was no significant difference in BMI and NLR. However, ALI assessment showed that ALI had a higher value in the surviving patient group with a statistically significant difference from the group who died in the hospital.
8eea62084ca7e541d918e823422bd82e Conclusion
Patients who died at a hospice or home exhibited significantly longer survival than those that died at hospital. Social background and spiritual factors are also taken into consideration, but ALI before treatment also considered factors that contribute to prognosis.
6f8b794f3246b0c1e1780bb4d4d5dc53
