TY - JOUR
T1 - Survival and prognostic factors in elderly patients receiving second-line chemotherapy for relapsed small-cell lung cancer
T2 - Results from the Japanese Joint Committee of Lung Cancer Registry
AU - Igawa, Satoshi
AU - Naoki, Katsuhiko
AU - Shintani, Yasushi
AU - Sekine, Ikuo
AU - Shukuya, Takehito
AU - Takayama, Koichi
AU - Inoue, Akira
AU - Okamoto, Isamu
AU - Kiura, Katsuyuki
AU - Takahashi, Kazuhisa
AU - Yamamoto, Nobuyuki
AU - Takiguchi, Yuichi
AU - Miyaoka, Etsuo
AU - Okumura, Meinoshin
AU - Yoshino, Ichiro
N1 - Funding Information:
The Japanese Joint Committee of Lung Cancer Registry and this study were supported by The Japan Lung Cancer Society , The Japanese Association for Chest Surgery , The Japanese Respiratory Society , The Japan Society for Respiratory Endoscopy , and The Japanese Association for Thoracic Surgery .
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/8
Y1 - 2020/8
N2 - Objectives: Most patients with small-cell lung cancer (SCLC) experience relapse because of the emergence of drug-resistant tumor cells. Therefore, second-line therapy is subsequently required to prolong their survival. However, it is unclear whether second-line chemotherapy can provide a survival benefit to elderly patients with relapsed SCLC. Therefore, this study aimed to evaluate survival and identify prognostic factors in an elderly population. Materials and methods: Based on a nationwide registry database of patients with SCLC (the Japanese Joint Committee of Lung Cancer Registry), we retrospectively reviewed medical records of patients aged ≥ 75 years with relapsed SCLC who subsequently received second-line chemotherapy. Survival time since the initiation of second-line chemotherapy was evaluated. Results: Among 731 patients aged ≥ 75 years with SCLC who were accumulated by the nationwide registry database, this study included 228 patients, comprising 190 men and 38 women with a median age of 78 years. The number of patients with performance status (PS) of 0−1 and 2−4 was 196 and 32, respectively. The overall survival (OS) and 1-year survival rates were 7.5 months and 24 %, respectively. A multivariate analysis identified PS, clinical stage at the time of starting first-line therapy, and the interval from the start of first-line therapy to that of second-line therapy as independent prognostic factors. Conclusion: This study with the nationwide registry database showed that among the relapsed elderly SCLC patients who received second-line chemotherapy, a substantial OS may be expected in patients with good PS, at an early clinical stage at the time of starting first-line therapy, and with a longer interval from the start of first-line therapy to that of second-line chemotherapy.
AB - Objectives: Most patients with small-cell lung cancer (SCLC) experience relapse because of the emergence of drug-resistant tumor cells. Therefore, second-line therapy is subsequently required to prolong their survival. However, it is unclear whether second-line chemotherapy can provide a survival benefit to elderly patients with relapsed SCLC. Therefore, this study aimed to evaluate survival and identify prognostic factors in an elderly population. Materials and methods: Based on a nationwide registry database of patients with SCLC (the Japanese Joint Committee of Lung Cancer Registry), we retrospectively reviewed medical records of patients aged ≥ 75 years with relapsed SCLC who subsequently received second-line chemotherapy. Survival time since the initiation of second-line chemotherapy was evaluated. Results: Among 731 patients aged ≥ 75 years with SCLC who were accumulated by the nationwide registry database, this study included 228 patients, comprising 190 men and 38 women with a median age of 78 years. The number of patients with performance status (PS) of 0−1 and 2−4 was 196 and 32, respectively. The overall survival (OS) and 1-year survival rates were 7.5 months and 24 %, respectively. A multivariate analysis identified PS, clinical stage at the time of starting first-line therapy, and the interval from the start of first-line therapy to that of second-line therapy as independent prognostic factors. Conclusion: This study with the nationwide registry database showed that among the relapsed elderly SCLC patients who received second-line chemotherapy, a substantial OS may be expected in patients with good PS, at an early clinical stage at the time of starting first-line therapy, and with a longer interval from the start of first-line therapy to that of second-line chemotherapy.
KW - Elderly patients
KW - Lung cancer registry
KW - Prognostic factor
KW - Second-line chemotherapy
KW - Small-cell lung cancer
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U2 - 10.1016/j.lungcan.2020.05.038
DO - 10.1016/j.lungcan.2020.05.038
M3 - Article
C2 - 32540559
AN - SCOPUS:85086442632
SN - 0169-5002
VL - 146
SP - 160
EP - 164
JO - Lung Cancer
JF - Lung Cancer
ER -
