USE THE RIGHT DOSE FOR ELDERLY PATIENTS

Lung Cancer. 2009 Jan 24. [Epub ahead of print]

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Dose intensity correlates with survival in elderly patients treated with chemotherapy for advanced non-small cell lung cancer.

Luciani A, Bertuzzi C, Ascione G, Di Gennaro E, Bozzoni S, Zonato S, Ferrari D, Foa P.

Medical Oncology Unit, S. Paolo Hospital, Milan, Italy.

INTRODUCTION: In elderly patients treated with chemotherapy for advanced non-small cell lung cancer (NSCLC), frequently an adequate dose intensity (DI) is difficult to be delivered. We therefore performed in this population a study to assess the delivered DI and its impact on clinical outcome. PATIENTS AND METHODS: Inclusion criteria were: age equal or greater than 70 years; cytological or histological diagnosis of NSCLC; stage IIIB or IV; no previous chemotherapy for advanced disease. Total relative dose intensity (RDI) was taken into account for the analysis. An RDI less than 80% was considered as suboptimal for tumor shrinkage. A survival comparison between subgroups (more or less than 80% RDI) was done. RESULTS: 107 patients were eligible for the analysis. Mean age was 74.3 years. PS was 0-1 in 92.5% of subjects. Mean number of comorbidities was 1.86. The most frequently chemotherapy regimens used were single agent vinorelbine and single agent gemcitabine. Overall mean RDI was 68%; 36% of patients received a RDI>80% of the originally planned one. The objective response rate (RR) was 55.2% and 33.3% respectively for patients receiving more or less than 80% of the RDI (p<0.01); style="background: transparent none repeat scroll 0% 0%; cursor: pointer; -moz-background-clip: -moz-initial; -moz-background-origin: -moz-initial; -moz-background-inline-policy: -moz-initial;" class="yshortcuts" id="lw_1233410993_13">response rate and overall survival.