Older Patients Benefit From Adjuvant Chemotherapy After Lung Cancer Surgery

Patients age 65 and older with early-stage lung cancer can benefit from adjuvant chemotherapy (chemotherapy after surgery) and do not experience more side effects when compared with younger patients, according to the results of a new study.

Using data from a clinical trial that compared the administration of cisplatin (Platinol) and vinorelbine (Navelbine) chemotherapy versus no chemotherapy for patients with early stage non-small cell lung cancer, researchers retrospectively compared the overall survival rate and occurrence of side effects for 327 patients younger than 65 and 155 patients older than 65. Of the older patients that received adjuvant chemotherapy, 66% were alive after five years, compared with 46% of patients that did not receive adjuvant chemotherapy.

Older patients received significantly fewer doses of chemotherapy and were less likely to complete their treatment. However, the rates of hospitalizations from treatment, side effects from treatment, and use of medications to prevent infection, such as filgrastim (Neupogen), were similar in older and younger patients. The reasons for the lower number of doses among older patients are not clear, but may be because both patients and doctors were unwilling to accept even mild side effects of treatment, given that the benefits of adjuvant chemotherapy were unproven. "With these findings, we hope that doctors and patients can be assured that older patients can have a prolonged life and can be given this treatment without a fear of increased side effects because of their age," said Carmela Pepe, MD, a clinical research fellow at Princess Margaret Hospital in Toronto and the study's lead author.

What This Means For Patients

Adjuvant chemotherapy is safe and effective for patients 65 and older with early-stage lung cancer and helps them live longer. Further study is needed in patients older than 75.