Cisplatin Combination Chemotherapy for Advanced Lung Cancer in the Aged

Abstract

Eleven aged patients over 65 years of age with advanced lung cancer (mean age=70.8±1.4, non-small cell:small cell=9:2, stage III:IV=5:6) were treated with combination chemotherapy consisting of cisplatin (50 or 80mg/m²) and vincaloid (vindesine 3mg/m² or etoposide 80mg/m²). To evaluate this cisplatin combination therapy, the aged group was compared with a young group consisting of eleven patients (mean age=53.3±1.7, non-small cell:small cell=9:2, stage III:IV=5:6) matched for cell type, stage and dose regimen. The mean dose of cisplatin was 58.2mg/m² in the aged and 63.6mg/m² in the younger group. A notable reduction in tumor size was observed in 9.1% of the aged and 27.3% of the young, while one-year survival rate was 63.6% in the aged and 72.7% in the young. The common side effects were nausea and vomiting, while diarrhea was seen in 18.2% of the aged. Neutropenia, anemia and thrombocytopenia were found in both groups and the time course of myelosuppression in the aged (18.2±0.8 days) was significantly shorter than that in the younger patients (22.0±1.4 days, p<0.05). With regard to nephrotoxicity, creatinine clearance rate in the aged decreased remarkably from 56.9 to 38.9ml/min, while there was no significant change in BUN, serum creatinine and urine NAG between the aged and the young. Disorders of electrolytes such as hypokalemia and hyponatremia were seen in 45.5% of the aged. We conclude that advanced lung cancer in the aged was effectively treated with cisplatin combination therapy with tolerable nephrotoxicity and myelosuppression.