Eur J Cardiothorac Surg 2005;28:912
© 2005 Elsevier Science NL
Reply to Altundag et al.
Hidehito Matsuoka
a
,
*
,
Morihito Okada
b
,
Toshihiko Sakamoto
b
,
Noriaki Tsubota
b
a Department of Surgery, Hyogo Prefectural Kaibara Hospital, 5208-1, Kaibara, Kaibara-cho, Tanba City, Hyogo 669-3395, Japan
b Department of Thoracic Surgery, Hyogo Medical Center for Adults, Akashi City, Hyogo, Japan
Received 7 September 2005;
accepted 13 September 2005.
* Corresponding author. Tel.: +81 795 0524; fax: +81 795 1276. (Email: hmatsuoka1{at}mac.com).
Key Words: Adjuvant chemotherapy • Non-small cell lung cancer • Elderly patients
My coauthors and I thank Altundag et al.'s suggestions on our report [1]. Although no patient had received adjuvant chemotherapy in a prescribed fashion in our 40 completely resected elderly cases, we recognize the value of postoperative chemotherapy. A role of single-agent therapy with uracil-tegafur or cisplatin-based adjuvant chemotherapy in patients with resected stage IB or stage II non-small cell lung cancer has come under review in recent years [2,3]. Elderly patients are often considered incapable of tolerating platinum-based systemic chemotherapy. But Langer and coauthors reported that response rate, toxicity, and survival in elderly non-small cell lung cancer patients receiving platinum-based treatment appeared to be similar to those in younger patients, although patients 70 years old or older had more comorbidities and could expect more leukopenia and neuropsychiatric toxicity [4]. Vinorelbine represents a well-tolerated treatment for elderly patients with advanced non-small cell lung cancer. It improved survival of elderly patients with advanced non-small cell lung cancer and had possibility to improve overall quality of life [5]. Advantage of these agents as adjuvant chemotherapy for elderly patients needs to be verified in prospective randomized studies. We think that advanced age alone should not preclude appropriate non-small cell lung cancer treatment.
References
- Matsuoka H, Okada M, Sakamoto T, Tsubota N. Complications and outcomes after pulmonary resection for cancer in patients 80–89 years of age. Eur J Cardiothorac Surg 2005;28:380-383.[Abstract/Free Full Text]
- Kato H, Ichinose Y, Ohta M, Hata E, Tsubota N, Tada H, Watanabe Y, Wada H, Tsuboi M, Hamajima N, Ohta M. A randomized trial of adjuvant chemotherapy with uracil-tegafur for adenocarcinoma of the lung. N Engl J Med 2004;350:1713-1721.[Abstract/Free Full Text]
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