NSCLC: most people aged 90 years and older do not receive treatment

  • Yang CJ & al.
  • Ann Thorac Surg
  • 12 Nov 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • More than half of patients aged ≥90 years with NSCLC do not receive treatment, even though treatment, especially surgery and stereotactic body radiation therapy (SBRT), offers significantly better survival.

Why this matters

  • This study is the first to focus specifically on NSCLC in patients aged ≥90 years.

Study design

  • 1,393,073 patients from the National Cancer Database diagnosed with NSCLC between 2004 and 2014, 7205 (0.5%) of whom were ≥90 years of age.
  • Funding: None disclosed.

Key results

  • 57.6% did not receive treatment.
  • Morbidity score, tumor size, metastasis, and treatment at an academic/research center were independent indicators for receiving treatment.
  • Treatments included radiation therapy alone (23.4%), chemoradiation (4.0%), SBRT (5.3%), surgery (3.7%), and chemotherapy (6.0%).
  • Overall OS was 4.9% at 5 years, and receipt of treatment was significantly associated with better OS (HR, 0.53; P<.001>
  • Greatest median OS benefit for stages I and II was from surgery (40.5 vs 10.0 months, and 32.6 vs 4.5 months, respectively) and from SBRT in stages III and IV (11.2 vs 2.3 months and 8.1 vs 1.5 months, respectively) compared with no treatment.

Limitations

  • Retrospective study.