Research Paper Volume 14, Issue 11 pp 4827—4838

Advanced age is not the decisive factor in chemotherapy of small cell lung cancer: a population-based study

Hanyu Rao1,2, *, , Shunping Zhou3, *, , Aihong Mei1, *, , Anjie Yao1, , Shuanshuan Xie1, ,

  • 1 Department of Respiratory Medicine, Shanghai 10th People’s Hospital, Tongji University School of Medicine, Shanghai 200072, China
  • 2 Tongji University School of Medicine, Shanghai 200092, China
  • 3 Department of Cardiology Medicine, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, China
* Equal contribution

Received: March 15, 2022       Accepted: May 19, 2022       Published: June 8, 2022
How to Cite

Copyright: © 2022 Rao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Objective: There is limited research on the impact of chemotherapy on the prognosis of different age group patients with small cell lung cancer (SCLC). The aim of this study was to explore the impact of chemotherapy on survival prognosis of elderly patients with SCLC.

Methods: Based on the Surveillance, Epidemiology and End Results (SEER) database, 57,460 SCLC patients between 2004 and 2015 were identified and divided into a ≤ 80 years group (n = 50,941) and a >80 years group (n = 6,519). Confounding factors were controlled by propensity score matching (PSM) analysis. Kaplan Meier (KM) analysis was performed to determine the impact of chemotherapy on overall survival (OS) and lung-cancer specific survival (LCSS) of the patients. Other variables that could affect survival of SCLC patients were also examined by COX analysis.

Results: KM analysis showed that both OS and LCSS were improved in chemotherapy group compared to those in non-chemotherapy group (log rank P < 0.001) in both age groups after PSM. Cox analysis demonstrated the survival benefit of chemotherapy in both ≤ 80 years group (OS: HR 0.435; 95% CI 0.424–0.447; LCSS: HR 0.436; 95% CI 0.424–0.448) and >80 years group (OS: HR 0.424; 95% CI 0.397–0.451; LCSS: HR 0.415; 95% CI 0.389–0.444). Additionally, the following parameters had a negative impact on survival of elderly patients: male sex, tumor location in main bronchus, increased stage, bilateral tumor, no surgery or radiation, and lower median household income.

Conclusions: Elderly patients with SCLC should be encouraged to receive chemotherapy provided their general conditions permit.


SCLC: Small cell cancer; NSCLC: Non-small cell cancer; SEER: Surveillance, Epidemiology, and End Results registry; OS: Overall survival; LCSS: Lung cancer-specific survival; HRs: Hazard ratios; CI: Confidence interval; PS: Performance status.