Treatment of small cell lung cancer in the elderly

To assess the progress and limitation of chemotherapy in the treatment of small cell lung cancer in the elderly, we analyzed 218 patients in a protocol study between 1982 and 1990. There were 101 elderly patients (age of ≧ 66 years) and 117 non-elderly patients (age of ≦ 65 years). Response to chemotherapy with or without chest irradiation was similar for the elderly and the non-elderly; the complete response rate was 52% for limited disease (LD) and 33% for extensive disease (ED) in the elderly, and it was 68% for LD and 23% for ED in the non-elderly. Survival figures of the two groups were similar; the median survival time was 12.6 monthes for the elderly and 14.5 months for the non-elderly, and the 3-year surival rate was 14% for both groups. Hematologic toxicity was more frequent and severe in the elderly than in the non-elderly but the difference was not significant. Non-hematologic toxicity was comparable for the two groups, with an exception that the elderly showed a tendency of being predisposed to renal toxicity. In conclusion, elderly patients eligible for entry into a protocol study can benefit from intensive treatment just as younger patients can.