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Management of Non-Small-Cell Lung Cancer in the Elderly

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28.7 Conclusions

Although the selected information from randomized clinical trials for therapeutic management of lung cancer in the elderly seems to need further evaluation, some conclusions can be drawn from the published data. First of all, treatment approaches should be tailored to individual patients and based upon the patient’s biological age and not their chronological age. For early stage lung cancer patients with good performance status and satisfactory cardiopulmonary reserves, the first therapeutic option is represented by surgery. In the presence of contraindications, radiotherapy is the alternative solution. Patients with a locally advanced disease and a good performance status should benefit more from radiochemotherapy, while frail patients should receive radiotherapy alone. Systemic chemotherapy offers the best potential results for metastatic disease. Single-agent chemotherapy with vinorelbine represents the first choice for elderly patients with good performance status, with the alternative of the single agent gemcitabine. In only very selective patients may the use of combination chemotherapeutic agents be given.

Physicians should overcome their fears for possible surgical complications or unmanageable chemoradiotherapy toxicities when treating elderly people. Careful selection of individuals and detailed clinical assessment of comorbidities leads to effective management of this disease.

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Authors and Affiliations

  1. 3rd Department of Medicine, Athens Medical School, Sotiria General Hospital, Athens, Greece

    Eleni Karapanagiotou

  2. Cancer Research UK Centre for Cell and Molecular Biology, Institute of Cancer Research, London, UK

    Kevin J. Harrington

  3. Oncology Unit, Sotiria General Hospital, Athens Medical School, Athens, Greece

    Konstantinos N. Syrigos

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  1. Eleni Karapanagiotou
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  2. Kevin J. Harrington
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  3. Konstantinos N. Syrigos
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Editors and Affiliations

  1. Sotiria General Hospital, Athens Medical School, Athens, Greece

    Konstantinos N. Syrigos MD, PhD

  2. Royal Marsden NHS Trust Hospitals, London, UK

    Christopher M. Nutting MB BA, MD, FRCR

  3. Evangelismos General Hospital, Athens Medical School, Athens, Greece

    Charis Roussos MD, MSc, PhD, MRS, FRCP(C)

  4. Faculty of Medicine, McGill University, Montreal, Canada

    Charis Roussos MD, MSc, PhD, MRS, FRCP(C)

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Karapanagiotou, E., Harrington, K.J., Syrigos, K.N. (2006). Management of Non-Small-Cell Lung Cancer in the Elderly. In: Syrigos, K.N., Nutting, C.M., Roussos, C. (eds) Tumors of the Chest. Springer, Berlin, Heidelberg . https://doi.org/10.1007/3-540-31040-1_28

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