Chemotherapy is Beneficial for Elderly Patients With Advanced Non-Small-Cell Lung Cancer: Analysis of Patients Aged 70-74, 75-79, and 80 or Older in Japan

A total of 3976 patients were analyzed in the Japanese large lung cancer database, and after adjustment with performance status (PS), a trend of survival benefit of chemotherapy remained in patients aged 80 years or older. Background: It remains to be determined in elderly patients with advanced non small-cell lung cancers (NSCLCs) if there is a benefit of chemotherapy in patients aged 80 or older. Methods: Using a database from the Japan National Hospital Organization Study Group for Lung Cancer from 1990 to 2005, 3 cohorts based on the age of diagnosis were examined in patients with stage IIIB and IV NSCLC. Cohort 1 was for 70- to 74-year-old patients, cohort 2 for 75- to 79-year old, and cohort 3 for 80 years and older (80+). Multivariate analysis of survival for each cohort was performed using the Cox regression method using the following covariates: age, PS, histology, stage, smoking status, and chemotherapy. Results: There were 1617 patients in cohort 1, 1349 in cohort 2, and 1010 in cohort 3. The number of patients treated with chemotherapy were 991 (61%) in cohort 1, 648 (48%) in cohort 2, and 286 (28%) in cohort 3. Multivariate analysis for overall survival (OS) showed that chemotherapy was a significant prognostic factor among cohort 1 (hazard ratio [HR], 0.540; 95% confidence interval [Cl], 0.481-0.607; P < .0001) and cohort 2 (HR, 0.715; 95% Cl, 0.632-0.810; P < .0001) and showed a benefit trend among cohort 3 (HR, 0.869; 95% Cl, 0.742-1.018; P=.0940). Conclusions: After adjustment for PS, a trend of survival benefit of chemotherapy remained in patients aged 80 or older.