Management of elderly patients with advanced non-small cell lung cancer in Turkey.

OBJECTIVE: Non-small cell lung cancer is a disease that affects the elderly. However, most patients older than 70 years are less likely to receive standard therapy than their younger counterparts and the aim of the present study was to determine age-dependent variation in efficacy. SUBJECTS AND METHODS: Between 2004-2008, 40 consecutive patients older than 70 years received treatment for advanced non-small cell lung cancer. All were evaluated for response and toxicity. Chemotherapy was either with cisplatin or carboplatin and double or single agents (vinorelbine, gemcitabine). Docetaxel was used as a second line therapy in selected cases. Patients were grouped according to age: group 1 (70-74 years), group 2 (>or= 75 years). RESULTS: Except for 4 cases, all received chemotherapy, and 61 % were given a cisplatin-containing regimen. Second-line therapy was given to 42.5% and grades 3-4 neutropenia was seen in 17 (42.5%). Only one patient died due to neutropenic fever. Nephrotoxicity was observed in 2 (5%) and one underwent hemodialysis. Overall survival was 10 months, with median survival periods for groups 1 and 2 of 13 and 10 months, respectively (p> 0.05). No differences were found regarding type of chemotherapy administered or adverse events between the 2 groups. CONCLUSION: Patients older than 75 years appear to deserve the same standard therapy for non-small cell lung cancer as that given to younger cases.

Prostate small cell carcinoma and skin metastases: a rare entity.

OBJECTIVES: To report a rare case of small cell carcinoma of the prostate with unusual skin metastasis. CLINICAL PRESENTATION AND INTERVENTIONS: A 60-year-old was evaluated for difficulty in urinating. Abdominal computed tomography scans revealed a prostatic mass invading the surrounding tissues and multiple perirectal, periprostatic, para-aortic and pericaval lymph nodes. Needle biopsy specimens showed both small cell carcinoma and adenocarcinoma. He was treated with combination chemotherapy: cisplatin and etoposide and bilateral orchiectomy. After six cycles of the chemotherapy, disease progressed and the patient did not respond to salvage therapy; hence, palliative care was instituted. During the follow-up, papillary lesions were observed in the scrotal skin; biopsy showed metastatic small cell carcinoma. CONCLUSION: Small cell carcinoma of the prostate is an aggressive disease with a highly metastatic potential; but skin metastases are very uncommon. It has poor prognosis despite therapy. Management resembles that of small cell carcinoma of the lung.