Treatment of the Elderly Patient with Small-Cell Lung Cancer

¹ The Division of Medical Oncology, Vanderbilt University School of Medicine, Nashville.

When potentially toxic anticancer therapy is indicated for the management of an aggressive malignancy such as SCLC, appropriate care must be taken in selecting older patients for treatment. Elderly patients with limited-stage disease and good performance status should not be denied the potential curative benefit of multimodality therapy solely on the basis of age. On the other hand, older patients with extensive-stage disease need not be subjected to the rigors of standard induction therapies, given the relative lack of curability in this setting. Some older patients with limited disease also may be candidates for less aggressive therapy, depending on their physiologic status and the presence of concomitant illness. Single-agent oral etoposide seems particularly well suited to these subsets of SCLC patients, but it must be administered with the same care with which any other potentially myelosuppressive therapy is given.