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Vol.57 No.6 contents | Japanese/English |
 | Full Text of PDF (285K) Article in Japanese |
- Invited Review Article -
The Therapeutic Approaches Applied in the Treatment of Non-small Cell Lung Cancer in Elderly Patients
Masafumi Yamaguchi11Department of Thoracic Oncology, National Kyushu Cancer Center, Japan
The improvement of the average life span in recent years has led to the aging of societies worldwide. In this setting, cancer is a major cause of death. Lung cancer, in particular, is a leading cause of death and the average age of patients with non-small cell lung cancer (NSCLC) has almost reached the mid-70s. Obviously, "fragility" is an important aspect in the treatment of elderly patients with NSCLC. In general, elderly patients are considered to have more comorbidities, including-but not limited to-diabetes mellitus, cardiovascular disorders, and respiratory disorders; many patients have multiple comorbidities. On the other hand, "fragility", which can reflect physiological, psychological or social factors, is used to describe conditions that can vary widely, even within the same age group. This often makes treatment decisions difficult. Treatment decisions should be made after considering the balance of risks and benefits; in other words, the balance of life expectancy obtained by the treatment, and the estimated life span of each patient. Needless to say, care should be taken to ensure that the treatment decision reflects the patient's wishes. This review focuses on the treatment modalities and strategies that are applied in the treatment of each stage of NSCLC (i.e., surgical resection, radiation and chemotherapy). Surgical resection is a suitable choice for early-stage NSCLC. At the present time, pulmonary lobectomy (or greater) resection, with the resection of the mediastinal lymph nodes, is the standard treatment for early-stage NSCLC; however, no prospective clinical trials have assessed the risks and benefits of surgery in elderly patients with early-stage NSCLC. The results, in terms of the survival benefit, risk, extent of resection (i.e., lesser resection or standard resection), and the recent results of stereotactic body radiotherapy will be reviewed. Furthermore, this report will discuss the development (based on prospective clinical trials) of chemotherapy or chemoradiotherapy for elderly patients with advanced NSCLC.
key words: Non-small cell lung cancer, Elderly patients, Surgery, Chemotherapy, Radiotherapy
JJLC 57 (6): 739-745, 2017
