Background. The aim of this study is to test the efficacy of gemcitabine as
single agent therapy in advanced non-small cell lung cancer in the elderly
by the evaluation of the clinical response, the survival increase and the
quality of life.
Methods. Nineteen patients (age > 65 years) with a PS >2, bearing an advanc
ed non-small cell lung cancer (IIIb-IV) not treated with chemotherapy befor
e, were charged between December 1996 and December 1998, Sixteen patients w
ere treated with gemcitabine at the dose of 1000 mg/mq 1-8-15 every 28 days
. CT scan, X-rays and skeletal scintigraphy were used in the evaluation of
the therapeutic response. The toxicity was estimated by following WHO index
es, The quality of life and the modification of the specific symptoms were
estimated by particular tests (Spitzer Index, IADL, EORTC-LC13).
Results, One complete response (6%), 4 partial responses (25%), 7 cases of
illness stabilization (43%), 4 cases of illness progression, were shown, On
e year of survival was found in 43% of cases with a 14 week of therapeutic
response and a global survival ratio of 12.4 weeks. Only 2 cases (12.5) bf
medium grade G3-leucopenia were found. All patients improved their quality
of life (IADL and Spitzer indexes) with reduction of symptoms, (EORTC-LC13)
and increase of self-agin and relationships.
Conclusions. The effectiveness of gemcitabine as single agent therapy as no
t yet been tested due to the scanty number of patients, nevertheless it mus
t be considered in relation to the improvement of the patient's quality of