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Management of Lung Cancer in the Elderly

Gaetano Rocco, MD, FRCSEd, Alessandro Morabito, MD, and Paolo Muto, MD

Non-small cell lung cancer (NSCLC) is the most common cancer in the world and the leading cause of cancer deaths in western countries [1]. Approximately two-thirds of lung cancer cases are diagnosed in patients aged >65 years and one-third are diagnosed in those aged >75 years. Therefore, NSCLC in elderly patients is an increasingly common problem faced by the medical community. Unfortunately, elderly patients are generally excluded from clinical trials because they are considered to have a high risk of treatment-related toxicity owing to concomitant comorbidities, physiological reductions in organ function, and changes in drug pharmacokinetics [2,3]. Few clinical trials are specifically designed to be performed in elderly patients. As a result, the treatment of lung cancer in elderly patients has often been based on the results of retrospective analyses. Furthermore, there is no firm agreement on the definition of “elderly”, and many believe that “biological” rather than “chronological” age should guide medical decisions. In general, however, the age of 70 years is commonly used as the cut-off point for patient selection in clinical trials. In this review, we discuss the available treatments for elderly patients.

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