Can G8 Scoring in Patients with Geriatric Lung Cancer Help to Determine Curative Treatment?

Objective: The median age at diagnosis of lung cancer is 70 years and there are limited data in the literature regarding the treatment of elderly patients. In elderly patients, comorbid diseases, poor performance, and toxicity may lead to a surge in physicians' curative treatment and may remain untreated. The aim of this study was to evaluate the results of treatment in patients older than 70 years whose performances were evaluated by using Geriatric 8 score and to find out the response to curative treatment.

Materials and Methods: 124 patients over 70 years of age were evaluated retrospectively. 68 patients with early stage or locally advanced non-small cell lung cancer who were inoperable but not suitable for stereotactic radiotherapy were evaluated retrospectively. Geriatric 8 (G8) screening test was used to identify elderly cancer patients who could benefit from curative treatment. Patients received curative chemoradiotherapy or radiotherapy alone.

Results: In all patients (68), overall survival (83% for 1 year, 66% for 2 years) was median 18 months and disease free survival (58% for 1 year, 34.1% for 2 years) was median 14 months. As the G8 score increased, a statistically significant increase was observed in overall and disease free survival. Having weight loss or not, presence of accompanying disease, having good or bad health situation, having body mass index above and below 21, and the usage number of medications below or above 3 affects overall and disease free survival. When only the patients who received radiochemotherapy (n = 43) were evaluated, the mean survival (free of the ECOG performance score) was 12.8 months with G8 score less than 14 and 29.17 months with G8 score 14 and above and were statistically significant (p = 0.000).

Conclusion: When making a treatment decision, clinical evaluation should be performed well in patients older than 70 years with non-small cell lung cancer (NSCLC). In our study, overall survival and disease free survival were found to be better in patients with a G8 score above 14. Therefore, we think that it may be appropriate to use curative concurrent radio chemotherapy in selected patients with high G8 score and not to decide on biological age in elderly patients.