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Elderly, chemotherapy, lung cancer

Taynah Cascaes Puty, Gabriel S A Brito, Mariana S Dias, Henrique C Miranda, Juliana R Chaves, Heryvelton L Freitas, Luís E W Carvalho
Metastatic breast cancer (MBC) entails an overall 5-year survival of approximately 25%. The choice of therapy is influenced by expression of the HER2 gene and hormone receptors, by a disease-free interval, and by age. The use of paclitaxel combined with gemcitabine (doublet protocol) has shown efficacy as first-line treatment for MBC in either initial or maintenance therapy when compared to monotherapy with paclitaxel. There is evidence showing that the doublet protocol is a good alternative to maintenance therapy in women under 50 years old...
September 2016: Case Reports in Oncology
Fábio Nasser Santos, Tiago Biachi de Castria, Marcelo Rocha Souza Cruz, Rachel Riera
BACKGROUND: Approximately 50% of patients with newly diagnosed non-small cell lung cancer (NSCLC) are over 70 years of age at diagnosis. Despite this fact, these patients are underrepresented in randomized controlled trials (RCTs). As a consequence, the most appropriate regimens for these patients are controversial, and the role of single-agent or combination therapy is unclear. In this setting, a critical systematic review of RCTs in this group of patients is warranted. OBJECTIVES: To assess the effectiveness and safety of different cytotoxic chemotherapy regimens for previously untreated elderly patients with advanced (stage IIIB and IV) NSCLC...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
Tetsuro Kawagoe, Yuta Maruki, Hiroyuki Nagoya, Yuki Kosugi, Teppei Akimoto, Hiroshi Yamawaki, Yasuhiro Kodaka, Mayumi Shimpuku, Nobue Ueki, Seiji Futagami, Kazumasa Miyake, Katsuhiko Iwakiri
An 81-year-old man was admitted with upper abdominal pain and weight loss. Esophagogastroduodenoscopy revealed a large tumor located from the gastric angle to the body. Histological analysis of a biopsy revealed a moderately differentiated adenocarcinoma. Computed tomography revealed metastases in the liver and lung and the patient was subsequently diagnosed with metastatic advanced gastric cancer. He was treated with chemotherapy using S-1 (80 mg/m(2)) and cisplatin (CDDP) (60 mg/m(2)). Twenty-two months after chemotherapy, the gastric tumor, and the nodules in the liver and lung, had disappeared...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Kosuke Kashiwabara, Hiroshi Semba, Shinji Fujii, Shinsuke Tsumura
BACKGROUND: Whether a full dosage of afatinib is tolerable and effective for elderly or low performance status (PS) patients with advanced refractory non-small-cell lung cancer (NSCLC) is unclear. METHODS: We retrospectively evaluated the tolerability and efficacy of afatinib in 10 patients (the majority elderly) with a low PS score (2 or 3), who had advanced refractory adenocarcinoma and were carrying active epidermal growth factor receptor mutations. Afatinib was administered at a starting dosage of 20 or 30mg/day, followed by 10mg increases in dose up to a maximum dosage of 40mg/day...
November 2016: Respiratory Investigation
Hirsh Koyi, Gunnar Hillerdal, Karl-Gustav Kölbeck, Daniel Brodin, Per Liv, Eva Brandén
BACKGROUND/AIM: Globally, an increasing proportion of cancer patients are aged >65 years and many are aged >70 years. Treatment of the elderly with lung cancer has, therefore, become an important issue. We performed a retrospective study of our patients to demonstrate how octogenarians with non-small cell lung cancer (NSCLC) are treated in real-life clinical practice. PATIENTS AND METHODS: This was a retrospective observational study of all elderly (≥80 years) patients with NSCLC referred to the Department of Respiratory Medicine and Allergy, Karolinska Hospital, Sweden, 2003-2010, and followed until June, 2016...
2016: Anticancer Research
Jie Chen, Xuezhi Hao, Fang Cheng, Tongtong Zhang, Puyuan Xing, Junling Li
BACKGROUND: As the prevalence of tobacco and the aging of the population, the incidence of lung cancer in the elderly rises. However, few elderly patients (older than 70 years old) with lung squamous cell carcinoma were involved into the clinical trials, which offered insufficient clinical evidence for these patients. Lung squamous cell carcinoma patients older than 80 years old were included in our study to analyze the clinical characteristics, treatment and prognostic factors, and to explore the optimal treatment choices for these patients...
October 20, 2016: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
Hisao Imai, Keita Mori, Nodoka Watase, Toshifumi Kazama, Sakae Fujimoto, Kyoichi Kaira, Masanobu Yamada, Koichi Minato
BACKGROUND: The effects of first-line chemotherapy on overall survival (OS) might be confounded by subsequent therapies in patients with small-cell lung cancer (SCLC). Therefore, the objective of our study was to determine the relationships between progression-free survival (PFS) or post-progression survival (PPS) and OS after first-line chemotherapy in elderly patients with extensive disease-SCLC (ED-SCLC), using individual level data. METHODS: Between July 1998 and December 2014, we analyzed 57 cases of elderly patients with ED-SCLC who were treated with carboplatin and etoposide as first-line chemotherapy...
November 2016: Thoracic Cancer
S Akyurek, B S Ozdemir, F Sert, D Yalman, G Yavas, M Cengiz, H Bakkal, A Yoney, K Kose
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Petr Szturz, Jan B Vermorken
The demographics of squamous cell carcinoma of the head and neck (SCCHN) is marked by a growing number of patients aged 65 and over, which is in line with global projections for other cancer types. In developed countries, more than half of new SCCHN cases are diagnosed in older people, and in 15 years from now, the proportion is expected to rise by more than 10%. Still, a high-level evidence-based consensus to guide the clinical decision process is strikingly lacking. The available data from retrospective studies and subset analyses of prospective trials suffer from a considerable underrepresentation of senior participants...
2016: Frontiers in Oncology
Hari Nathan, Huiying Yin, Sandra L Wong
BACKGROUND: Recent attention has focused on the ability to rescue patients from postoperative complications and prevent short-term mortality. However, it is unknown whether patients rescued from complications after complex cancer resections have long-term survival outcomes similar to those of patients without complications. METHODS: From 2005 to 2009 Surveillance, Epidemiology, and End Results (SEER)-Medicare data, the study identified elderly patients who underwent resection for cancers of the esophagus, lung, or pancreas...
September 12, 2016: Annals of Surgical Oncology
Daniel M Gilden, Joanna M Kubisiak, Gerhardt M Pohl, Daniel E Ball, David E Gilden, William J John, Stewart Wetmore, Katherine B Winfree
AIM: To assess the cost-effectiveness of first-line pemetrexed/platinum and other commonly administered regimens in a representative US elderly population with advanced non-squamous non-small cell lung cancer (NSCLC). MATERIALS AND METHODS: This study utilized the Surveillance Epidemiology and End Results (SEER) cancer registry linked to Medicare claims records. The study population included all SEER-Medicare patients diagnosed in 2008-2009 with advanced non-squamous NSCLC (stages IIIB-IV) as their only primary cancer and who started chemotherapy within 90 days of diagnosis...
February 2017: Journal of Medical Economics
Mark Zaki, Michael Dominello, Gregory Dyson, Shirish Gadgeel, Antoinette Wozniak, Steven Miller, Peter Paximadis
BACKGROUND: The objective of this study was to review our institution's experience among patients with locally advanced non-small-cell lung cancer (LA-NSCLC) treated with chemotherapy and radiation and to determine the prognostic significance of age. PATIENTS AND METHODS: Patients were included if they underwent sequential or concurrent chemoradiotherapy from 2006 to 2014 for LA-NSCLC. Patients were stratified according to age ≤70 and >70 years. Kaplan-Meier and Cox regression methods were performed to evaluate overall survival (OS) and progression-free survival (PFS)...
July 22, 2016: Clinical Lung Cancer
David E Dawe, David Christiansen, Anand Swaminath, Peter M Ellis, Janet Rothney, Rasheda Rabbani, Ahmed M Abou-Setta, Ryan Zarychanski, Salaheddin M Mahmud
In stage III non-small cell lung cancer (NSCLC), the standard of care in young patients is chemoradiotherapy, but this standard is not as clearly established for older patients. We aimed to determine the efficacy and harm associated with chemoradiotherapy versus radiotherapy alone in elderly (≥70 years), stage III NSCLC patients through a systematic review. We conducted a systematic search of MEDLINE, EMBASE, CENTRAL, Scopus, Web of Science and conference proceedings. Two reviewers independently identified randomized trials (RCT) and extracted trial-level data...
September 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Toshio Kubo, Keiichi Fujiwara, Katsuyuki Hotta, Toshiaki Okada, Shoichi Kuyama, Shingo Harita, Takashi Ninomiya, Haruhito Kamei, Shinobu Hosokawa, Akihiro Bessho, Tadashi Maeda, Toshiyuki Kozuki, Nobukazu Fujimoto, Kiichiro Ninomiya, Mitsuhiro Takemoto, Susumu Kanazawa, Nagio Takigawa, Masahiro Tabata, Mitsune Tanimoto, Hiroshi Ueoka, Katsuyuki Kiura
PURPOSE: The treatment outcome in elderly patients with limited-disease small-cell lung cancer (LD-SCLC) remains poor. We carried out a phase II trial of split topotecan and cisplatin (TP) therapy and sequential thoracic radiotherapy for elderly LD-SCLC patients as a follow-up to our previous phase I trial. METHODS: In total, 30 patients aged 76 years or older, with untreated LD-SCLC were enrolled. Four courses of topotecan (1.0 mg/m(2), days 1-3) and cisplatin (20 mg/m(2), days 1-3) were administered, followed by thoracic radiotherapy (1...
October 2016: Cancer Chemotherapy and Pharmacology
Jianqing Chen, Jianbo Chen, Xiaoan Wu, Tao Shi, Meiling Kang
PURPOSE: The efficacy of targeted agents (TAs) in the treatment of elderly patients with advanced non-small-cell lung cancer (NSCLC) remains controversial. We aimed to assess the efficacy of TAs in the treatment of advanced NSCLC in this setting. MATERIALS AND METHODS: Relevant trials were identified by searching electronic databases and conference meetings. Prospective randomized controlled trials assessing chemotherapies with or without TAs in elderly patients with advanced NSCLC were included...
2016: OncoTargets and Therapy
D K Woolf, B J Slotman, C Faivre-Finn
Radiotherapy has been shown to play a key role in the management of small cell lung cancer. There are well-established data in the literature for the use of concurrent chemoradiotherapy for stage I-III disease, although key questions remain over the timing of radiation, the optimal dose/fractionation and particularly once versus twice daily treatment, the use of elective nodal irradiation and drug combinations. Data for the use of thoracic radiation in stage IV disease, after chemotherapy, have recently become available and are leading to a change in practice...
November 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Constantin Volovat, Igor Bondarenko, Oleg Gladkov, Anton Buchner, Andreas Lammerich, Udo Müller, Peter Bias
PURPOSE: Lipegfilgrastim, a glycoPEGylated recombinant granulocyte colony-stimulating factor (G-CSF), reduces neutropenia duration and febrile neutropenia (FN) incidence in patients with cancer receiving myelosuppressive chemotherapy. A phase 3 trial of lipegfilgrastim was conducted in patients with advanced non-small cell lung cancer (NSCLC) receiving cisplatin/etoposide (which produces mild-to-moderate myelosuppression). Because patients aged >65 years are at higher risk for FN versus younger patients, this post hoc analysis compared outcomes in elderly (>65 years) versus younger participants in this trial...
August 8, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Fábio Nasser Santos, Marcelo Rocha Souza Cruz, Rachel Riera
Clinical Question: Do patients above 70 years of age with newly diagnosed advanced non-small-cell lung cancer benefit from platinum-based combination or should they receive non-platinum agents either as single-agent or in combination? Bottom Line: For fit elderly patients platinum-based combination is associated with better overall survival, progression-free survival, and objective response rate, however this improvement should be counter balanced against the higher risk of major adverse events (AE)...
December 1, 2016: JAMA Oncology
Lukas Käsmann, Stefan Janssen, Dirk Rades
AIM: Elderly patients require special consideration in oncology treatment. Small-cell lung cancer (SCLC) is a highly aggressive tumour with dismal prognosis. The present study focused on prognostic factors in elderly patients irradiated for limited-disease SCLC. PATIENTS AND METHODS: In 36 patients aged ≥65 years, 11 factors were evaluated for the impact on survival, namely gender, Karnofsky performance score, body mass index, T-category, N-category, tobacco consumption, time from SCLC diagnosis to irradiation, smoking during irradiation, simultaneous chemotherapy, radiation dose and prophylactic cranial irradiation...
August 2016: Anticancer Research
Jianwen Qin, Guangsheng Li, Jingmin Zhou
OBJECTIVE: To investigate the clinical features, diagnosis, and treatment status of elderly patients with chronic obstructive pulmonary disease (COPD) complicated with lung cancer. PATIENTS AND METHODS: This was a retrospective study of 206 patients aged >60 years with COPD and newly diagnosed lung cancer at the Tianjin Chest Hospital Respiratory Centre between September 2008 and September 2013. Lung function, radiology, and clinical data were retrieved. RESULTS: Among all patients, 57% (117/206) were hospitalized due to acute COPD aggravation, 47% (96/206) had COPD grade III or IV, 95% (195/206), showed diffusion dysfunction in pulmonary function examination, 90% (185/206) had a history of smoking, and 26% (54/206) were treated with inhaled corticosteroids for COPD treatment...
2016: International Journal of Chronic Obstructive Pulmonary Disease
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