Cisplatin-based Chemotherapy in Elderly Patients with Non-small Cell Lung Cancer

Background: The use of cisplatin-based combination chemotherapy in elderly patients with advanced non-small cell lung cancer (NSCLC) remains an issue of debate. Methods: We retrospectively reviewed the medical records of all patients ≥ 70 years with stage IIIB and stage IV NSCLC who received chemotherapy between 2000 and 2007 at our hospital. Data on demographic information, chemotherapy regimen and cycle, response, toxicity, and survival time were collected. Survival was analyzed by the Kaplan-Meier method and log-rank test. Results: A total of 102 elderly patients with advanced NSCLC received chemotherapy with a combination of cisplatin plus either vinorelbine or gemcitabine (the cisplatin-based combination group), or single-agent vinorelbine or gemcitabine (the single-agent group). The response rate was 46% in the cisplatin-based combination group, and 25% in the single-agent group (p = 0.03). The median survival was 11.1 months (95% confidence interval, CI, 9.24–12.96] in the cisplatin-based combination group, and 8.9 months (95% CI, 7.68–10.14) in the single-agent group (p = 0.06), and 1-year survival rates were 38.6% and 22.4%, respectively. The median progression-free survival was 7.9 months (95% CI, 5.62–10.18) and 5.8 months (95% CI, 4.78–6.82), respectively (p = 0.03). Grade 3–4 anemia and neutropenia were more frequent in the cisplatin-based combination group. Other toxicities were mild and generally well tolerated in the two groups. Conclusion: Elderly patients ≥ 70 years with advanced NSCLC can tolerate and benefit from cisplatin-based combination chemotherapy. Cisplatin-based chemotherapy may be considered as an option in the treatment of elderly patients with advanced NSCLC