PMID- 20038726
OWN - NLM
STAT- MEDLINE
DCOM- 20100218
LR  - 20211020
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 28
IP  - 4
DP  - 2010 Feb 1
TI  - Adverse events among the elderly receiving chemotherapy for advanced 
      non-small-cell lung cancer.
PG  - 620-7
LID - 10.1200/JCO.2009.23.8485 [doi]
AB  - PURPOSE: To describe chemotherapy use and adverse events (AEs) for 
      advanced-stage, non-small-cell lung cancer (NSCLC) in community practice, 
      including descriptions according to variation by age. METHODS: We interviewed 
      patients with newly diagnosed, stages IIIB and IV NSCLC in the population-based 
      cohort studied by the Cancer Care Outcomes Research and Surveillance Consortium, 
      and we abstracted the patient medical records. AEs were medical events occurring 
      during chemotherapy. Using logistic regression, we assessed the association 
      between age and chemotherapy; with Poisson regression, we estimated event rate 
      ratios and adjusted the analysis for age, sex, ethnicity, radiation therapy, 
      stage, histology, and presence and grade of 27 comorbidities. RESULTS: Of 1,371 
      patients, 58% (95% CI, 55% to 61%) received chemotherapy and 35% (95% CI, 32% to 
      38%) had AEs. After adjustment, 72% (95% CI, 65% to 79%) of those younger than 55 
      years and 47% (95% CI, 42% to 52%) of those age 75 years and older received 
      chemotherapy. Platinum-based therapies were less common in the older-age groups. 
      Pretreatment medical event rates were 18.6% for patients younger than 55 years 
      and were only 9.2% for those age 75 years and older (adjusted rate ratio, 0.49; 
      95% CI, 0.26 to 0.91). In contrast, older adults were more likely to have AEs 
      during chemotherapy. The adjusted rate ratios compared with age younger than 55 
      years were 1.70 for 65- to 74-year-olds (95% CI, 1.19 to 2.43) and 1.34 for those 
      age 75 years and older (95% CI, 0.90 to 2.00). CONCLUSION: Older patients who 
      received chemotherapy had fewer pretherapy events than younger patients and were 
      less likely to receive platinum-based regimens. Nevertheless, older patients had 
      more adverse events during chemotherapy, independent of comorbidity. Potential 
      implicit trade-offs between symptom management and treatment toxicity should be 
      made explicit and additionally studied.
FAU - Chrischilles, Elizabeth A
AU  - Chrischilles EA
AD  - Department of Epidemiology, University of Iowa, Iowa City, IA 52242, USA. 
      e-chrischilles@uiowa.edu.
FAU - Pendergast, Jane F
AU  - Pendergast JF
FAU - Kahn, Katherine L
AU  - Kahn KL
FAU - Wallace, Robert B
AU  - Wallace RB
FAU - Moga, Daniela C
AU  - Moga DC
FAU - Harrington, David P
AU  - Harrington DP
FAU - Kiefe, Catarina I
AU  - Kiefe CI
FAU - Weeks, Jane C
AU  - Weeks JC
FAU - West, Dee W
AU  - West DW
FAU - Zafar, S Yousuf
AU  - Zafar SY
FAU - Fletcher, Robert H
AU  - Fletcher RH
LA  - eng
GR  - 5 U18 HS016094/HS/AHRQ HHS/United States
GR  - U01 A093326/PHS HHS/United States
GR  - U01 CA093329/CA/NCI NIH HHS/United States
GR  - U01 CA093348/CA/NCI NIH HHS/United States
GR  - U01 CA093324/CA/NCI NIH HHS/United States
GR  - U01 CA093332/CA/NCI NIH HHS/United States
GR  - U01 CA01013/CA/NCI NIH HHS/United States
GR  - U18 HS016094/HS/AHRQ HHS/United States
GR  - U01 CA093344/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20091228
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
SB  - IM
EIN - J Clin Oncol. 2010 May 1;28(13):2314
CIN - J Clin Oncol. 2010 Feb 1;28(4):523-6. PMID: 20038720
MH  - Adenocarcinoma/*drug therapy/secondary
MH  - Aged
MH  - Antineoplastic Combined Chemotherapy Protocols/*adverse effects
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/secondary
MH  - Carcinoma, Squamous Cell/*drug therapy/secondary
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Prognosis
MH  - Prospective Studies
MH  - Survival Rate
MH  - Treatment Outcome
PMC - PMC2815997
COIS- Authors' disclosures of potential conflicts of interest and author contributions 
      are found at the end of this article.
EDAT- 2009/12/30 06:00
MHDA- 2010/02/19 06:00
PMCR- 2011/02/01
CRDT- 2009/12/30 06:00
PHST- 2009/12/30 06:00 [entrez]
PHST- 2009/12/30 06:00 [pubmed]
PHST- 2010/02/19 06:00 [medline]
PHST- 2011/02/01 00:00 [pmc-release]
AID - JCO.2009.23.8485 [pii]
AID - 38485 [pii]
AID - 10.1200/JCO.2009.23.8485 [doi]
PST - ppublish
SO  - J Clin Oncol. 2010 Feb 1;28(4):620-7. doi: 10.1200/JCO.2009.23.8485. Epub 2009 
      Dec 28.