First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data.

Aging of the population has led to an increase in the prevalence of cancer among older adults. In Japan, single agent chemotherapy was recommended for advanced non-small cell lung cancer (NSCLC) for those, who were aged ≥75 years, while the Western guidelines did not recommend a specific regimen. In...

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Autores principales:	Shoko Noda-Narita, Asuka Kawachi, Ayako Okuyama, Ryo Sadachi, Akihiro Hirakawa, Yasushi Goto, Yasuhiro Fujiwara, Takahiro Higashi, Kan Yonemori
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d0319cd471454b75a645aa8becb8997b
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spelling	oai:doaj.org-article:d0319cd471454b75a645aa8becb8997b2021-12-02T20:14:28ZFirst-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data.1932-620310.1371/journal.pone.0257489https://doaj.org/article/d0319cd471454b75a645aa8becb8997b2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257489https://doaj.org/toc/1932-6203Aging of the population has led to an increase in the prevalence of cancer among older adults. In Japan, single agent chemotherapy was recommended for advanced non-small cell lung cancer (NSCLC) for those, who were aged ≥75 years, while the Western guidelines did not recommend a specific regimen. In clinical practice, physicians are required to decide the treatment based on a lack of enough evidence. This study aimed to examine the prescribing patterns of first-line chemotherapy according to age in the real-world practice. Data from the survey database of Diagnostic Procedure Combination and hospital-based cancer registries of designated cancer centers nationwide were used. The first-line chemotherapy regimens among 9,737 patients who were diagnosed with advanced lung cancer between January and December 2013, were identified and compared based on age. We found that the proportion of patients receiving chemotherapy decreased with age; 80.0%, 70.4%, 50.6%, and 30.2% of patients aged 70-74, 75-79, 80-84, and ≥ 85 years, respectively, received chemotherapy. Among them, platinum doublets were prescribed for 62.7% of the patients who were aged ≥ 70 years, and 60.7% of the patients who were aged ≥ 75 years with no driver mutations in NSCLC; only 37.6% of them received single agents. Patients who were aged ≥ 80 years also preferred platinum doublets (35.6%). Carboplatin was commonly prescribed in all age groups; only 28.4% of those receiving platinum doublets selected cisplatin. In this study, platinum doublets were identified as the most commonly prescribed regimen in those who were aged ≥ 70 years. Despite recommendations of Japanese guidelines for NSCLC, 60.7% of those who were aged ≥75 years received platinum doublets. Additionally, patients who were aged ≥ 80 years also received systemic chemotherapy, including platinum doublets; age did not solely influence regimen selection.Shoko Noda-NaritaAsuka KawachiAyako OkuyamaRyo SadachiAkihiro HirakawaYasushi GotoYasuhiro FujiwaraTakahiro HigashiKan YonemoriPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257489 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Shoko Noda-Narita Asuka Kawachi Ayako Okuyama Ryo Sadachi Akihiro Hirakawa Yasushi Goto Yasuhiro Fujiwara Takahiro Higashi Kan Yonemori First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data.
description	Aging of the population has led to an increase in the prevalence of cancer among older adults. In Japan, single agent chemotherapy was recommended for advanced non-small cell lung cancer (NSCLC) for those, who were aged ≥75 years, while the Western guidelines did not recommend a specific regimen. In clinical practice, physicians are required to decide the treatment based on a lack of enough evidence. This study aimed to examine the prescribing patterns of first-line chemotherapy according to age in the real-world practice. Data from the survey database of Diagnostic Procedure Combination and hospital-based cancer registries of designated cancer centers nationwide were used. The first-line chemotherapy regimens among 9,737 patients who were diagnosed with advanced lung cancer between January and December 2013, were identified and compared based on age. We found that the proportion of patients receiving chemotherapy decreased with age; 80.0%, 70.4%, 50.6%, and 30.2% of patients aged 70-74, 75-79, 80-84, and ≥ 85 years, respectively, received chemotherapy. Among them, platinum doublets were prescribed for 62.7% of the patients who were aged ≥ 70 years, and 60.7% of the patients who were aged ≥ 75 years with no driver mutations in NSCLC; only 37.6% of them received single agents. Patients who were aged ≥ 80 years also preferred platinum doublets (35.6%). Carboplatin was commonly prescribed in all age groups; only 28.4% of those receiving platinum doublets selected cisplatin. In this study, platinum doublets were identified as the most commonly prescribed regimen in those who were aged ≥ 70 years. Despite recommendations of Japanese guidelines for NSCLC, 60.7% of those who were aged ≥75 years received platinum doublets. Additionally, patients who were aged ≥ 80 years also received systemic chemotherapy, including platinum doublets; age did not solely influence regimen selection.
format	article
author	Shoko Noda-Narita Asuka Kawachi Ayako Okuyama Ryo Sadachi Akihiro Hirakawa Yasushi Goto Yasuhiro Fujiwara Takahiro Higashi Kan Yonemori
author_facet	Shoko Noda-Narita Asuka Kawachi Ayako Okuyama Ryo Sadachi Akihiro Hirakawa Yasushi Goto Yasuhiro Fujiwara Takahiro Higashi Kan Yonemori
author_sort	Shoko Noda-Narita
title	First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data.
title_short	First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data.
title_full	First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data.
title_fullStr	First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data.
title_full_unstemmed	First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data.
title_sort	first-line treatment for lung cancer among japanese older patients: a real-world analysis of hospital-based cancer registry data.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/d0319cd471454b75a645aa8becb8997b
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First-line treatment for lung cancer among Japanese older patients: A real-world analysis of hospital-based cancer registry data.

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