82 Treatment of small cell lung cancer (SCLC) in elderly patients (E.P.)

Aim to analyze the treatment outcome for E.P. (i.e. older than 70 yrs) affected by SCLC treated at our institution with the same protocol and entry criteria as younger pts. Results From 1980 to 1988, 286 patients (M/F 262/24) were treated; 254 (88%) were younger than 70 (Y.P.) while 32 (12%) were E.P., Pt. characteristics were similar in both age groups: median PS was 80% vs 80%, increased LDH 46% vs 47%, weight loss 55% vs 53%, limited disease (LD) stage 58% vs 56%. stages I-II 18% vs 18%, IIIA 26% vs 31%, IIIB 17.3% vs 15.6%, IV 38.2% vs 34.4%, operable pts 35% vs 31% respectively in Y.P. and E.P. Surgery, however, was performed in 73 (28.7%) Y.P. and in only 6 (18.8%) E.P. Chemotherapy (CT) consisted of 6 courses of alternating CAV/PE for extensive disease pts. LD pts were treated with 4 cycles of CT plus surgery in operable pts; RT (44 Gy) followed CT in inoperable pts. Two pts had an early death before starting treatment, 3 pts were submitted only to surgery fur refusal of CT, all in Y.P. group. In 44 pts surgery was followed by adjuvant CT. A total of 237 pts were submitted to primary CT, 210 pts were Y.P., 27 E.P.: objective response rates were 72% and 63% respectively, with 26.7% (56 pts.) and 22.2% (6 pts.) CR. Median survival was 11.6 and 12 months and 3 yrs survivals were 18% and 17.8%. Cox proportional hazard survival analysis showed no significant differences by age. Conclusions compliance, responses and survival were similar in Y.P. and E.P. treated for SCLC. Thus an aggressive therapeutical approach seems to be justified in selected patients older than 70 yrs.