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E. Brandén



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    MO24 - NSCLC - Chemotherapy III (ID 110)

    • Event: WCLC 2013
    • Type: Mini Oral Abstract Session
    • Track: Medical Oncology
    • Presentations: 2
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      MO24.01 - Treatment of elderly (70 years or older) with lung cancer. A four-year material in clinical practice from Karolinska University Hospital - Sweden. (ID 2562)

      10:30 - 10:35  |  Author(s): E. Brandén

      • Abstract
      • Presentation
      • Slides

      Background
      Sixty percent of all neoplasms and two-thirds of all deaths due to cancer occur in persons older than 65 years. More than 50% of patients with lung cancer are older than 65 years and 30% older than 70 years. With more persons surviving to older age treatment of the elderly with lung cancer has become an important issue.

      Methods
      All patients 70 years or older with non small cell lung cancer (NSCLC) seen at the Department of Respiratory Medicine and Allergy, Karolinska Hospital from 2003 to 2006 were retrospective reviewed. In all 659 patients were analyzed.

      Results
      The mean age was 78 years, 55.5 (%) were men. 93,2% of the males and 82.1% of the females were smokers or former smokers. There was a significant differences between smoking habbits among the genderas (P<0.0001). 77.2 (%) had PS 0-2. 38.4% adenocarcinoma, 9.8% with small cell lung cancer, 20.6% squamous cell carcinoma, 15.6% had clinical lung cancer and the others broncheoalveolar cell carcinoma or low differentiated carcinoma were 15.3%. 10.7% underwent radical surgery, 24% received chemotherapy only, 17.8% radiotherapy against the tumour (there of stereotactic 4.4%), and 3.7% concomitant chemo-radiotherapy. 7.4% received radiotherapy against metastases, and 32.1% had no therapy. Only 10% were given second-line chemotherapy. Median survival for patients 70-75, 76-80 and >80 years was 231, 250 resp 213. Median survival for patients with PS=0 was 810 days, those with PS=3 only 109 days. Median survival was 610 days for patients given second line chemotherapy. Survival among those who received only first line chemotherapy was 285 days.

      Conclusion
      Significant survival among patients given second line chemotherapy (p<0.003). Significant survival among patients between 70-80 versus > 80 years old (P<0.001). Treatment of elderly patients with lung cancer is feasible if they have a good PS and seems to result in prolonged survival.

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      MO24.03 - Treatment of elderly patients ( > 70 years ) with non-small cell lung cancer given chemotherapy. A four-year material in clinical practice from Karolinska University Hospital - Sweden. (ID 3257)

      10:40 - 10:45  |  Author(s): E. Brandén

      • Abstract
      • Presentation
      • Slides

      Background
      Sixty percent of all neoplasms and two-thirds of all deaths due to cancer occur in persons older than 65 years. More than 50% of patients with lung cancer are older than 65 years and 30% older than 70 years. With more persons surviving to older age treatment of the elderly with lung cancer has become an important issue.

      Methods
      All patients 70 years or older with non small cell lung cancer (NSCLC) given chemotherapy at the Department of Respiratory Medicine and Allergy, Karolinska Hospital from 2003 to 2006 were retrospective reviewed. In all 149 patients were analyzed.

      Results
      The mean age was 75,5 years and median 74 years. 54.4 % were male. 96,3% of the males and 88.2% of the females were smokers or former smokers. There was a significant differences between smoking habitts among the genderas (P<0.05). 16.1% , 50.3% and 27.5% had PS 0 resp 1 resp 2. 57.7% and 30.9% with stage IV resp III . 32.9% adenocarcinoma, 24.8% squamous cell carcinoma, and the others broncheoalveolar cell carcinoma or low differentiated carcinoma were 24.2%. 18.1% of the patients had no histopathological diagnosis – clinical diagnosis. Almost all the patients were given carboplatin/gemcitabin as first line chemotherapy regardless of histology. Four cycles was given to almost all the patients. Only 27.5% were given second-line chemotherapy. Median overall survival was 285 days. Longer overall survival among 70-80 vs > 80 years old patients.

      Conclusion
      Significant survival among patients between 70-80 versus > 80 years old.. Treatment of elderly patients with lung cancer is feasible if they have a good PS and seems to result in prolonged survival.

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    P2.10 - Poster Session 2 - Chemotherapy (ID 207)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P2.10-042 - Lung cancer among Swedish and imigrants. Incidens, histopathology, treatment and survival. (ID 2584)

      09:30 - 09:30  |  Author(s): E. Brandén

      • Abstract

      Background
      Lung cancer represents the leading cause of cancer-related death world wide. Several studies have shown that the risk of developing lung cancer is associated with socioeconomic status. Recently a Swedish study showed that socioeconomically disadvantaged groups with NSCLC receive less intensive care. Low education remained an independent predictor of poor survival only in women with early stage disease. Foreign-born people constitute 12.5% of the Swedish population in Sweden.

      Methods
      A retrospective analysis of all patients with lung cancer at the Department of Respiratory Medicine and Allergy, Karolinska University Hospital - Solna during 030101—061231. In all, 1353 cases of lung cancer were diagnosed in which 157 (11.6%) were immigrants. The mean age in Swedish patients was 69, median 70 and range 38-96 years. The figures for the immigrants was 65, 66 respectively 38-90 years.91,3% of the Swedish and 92,3% of the immigrant patients were either smoker or former smoker. There was no significant differences between the groups.

      Results
      In 105 (8,8%) Swedish and 7 (4,5%) of the immigrants the diagnosis was clinical Adenocarcinoma was the most common subtype found in both Swedish and immigrant patients 44,7% respectively 40,1%, squamous cell carcinoma 17,5% resp 21,7% and small cell lung cancer 12,2% respectively 14% . No significance differences between the groups.19,1% of the Swedish and 14% of the immigrants were diagnosed as stage I, 2,4% resp 4,4% as stage II, 7,9% resp 7% as stage IIIa and 70,4% resp 74,5% as stage IIIB/IV. Nearly 86% of the Swedish and 84,1% of the immigrants had PS 0-2 and 14,3% resp 15,9% had PS 3-4. Chemotherapy given to 387(32,4%) of the Swedish and 58(36,9%) of the immigrants, concomitant chemo-radiotherapy to 90(7,5%) resp 16(10,2%), radiotherapy against the tumor 8,4% resp 8,3%, SBRT to 2,7% resp 1,3%. Surgery were performed among 9,1% of the Swedish and 10,8% of the immigrants, 5,9% resp 4,5% given adjuvant chemotherapy. Approximately 20% of the Swedish and 15,9% of the immigrants given no therapy at all. There was no significant differences in treatment between the two groups p<0.551.The median survival time for the Swedish patients was 245 days and for other nationalities it was 269 days with no statistical significant difference. For Swedish female patients the median survival time was 273 days and for females from other nationalities it was 329 days with no significant difference.No significant differences in survival and staging between the swedish and the imigrants. There was no significant difference in survival between Swedish and non-Swedish patients within performance status groups.

      Conclusion
      In this study, we used cohort of patients with lung cancer (except carcinoid), with a focus on ethnicity, to determine whether racial/ethnic disparities exist in overall survival. Another objective of our analysis was to determine whether any differences in survival could be attributed to disease-associated variables. To our best knowledge no previous study has investigated the incidens of lung cancer in immigrants in Sweden. This study showed no significant difference in survival between immigrants and Swedish patients with lung cancer.