Prognostic Factors in Elderly Patients with Advanced Non-Small Cell Lung Cancer Treated with Chemotherapy

Objective: The prognosis of advanced non-small cell lung cancer (NSCLC) is poor. The aim of this study was to assess the outcome of chemotherapy for elderly patients with advanced NSCLC, focusing on the prognostic factors influencing survival. Methods: We reviewed retrospectively the medical records of 109 elderly patients with advanced NSCLC treated with chemotherapy from January 1999 to December 2006. Collected data included demographic information, clinical assessment before therapy, and information on treatment and outcome. Survival was estimated using the Kaplan-Meier method, and prognostic factors were analyzed by the log-rank test and Cox regression model. Results: The median survival time for the entire group was 10.5 (95% confidence interval: 9.15-11.88) months, with 1- and 2-year survival rates of 31.2 and 9.2%, respectively. Univariate analysis showed that performance status (PS; p = 0.013), comorbidity (p = 0.006), chemotherapy cycle (p = 0.006) and second-line therapy (p = 0.002) significantly influenced overall survival. In multivariate analysis, comorbidity, chemotherapy cycles and second-line therapy were identified as independent prognostic factors. Conclusions: Survival of elderly patients with advanced NSCLC treated with chemotherapy is significantly influenced by the patient's PS, comorbidity, chemotherapy cycle and second-line therapy. These results may help to choose the appropriate treatment in clinical practice. Copyright (C) 2009 S. Karger AG, Basel