Abstract 1841P
Background
Lung Cancer is most diagnosed over the age of 70 years. This population have an increasing risk of frailty and these impact cancer treatment tolerance, quality of life and survival. We performed a retrospective study to look at whether aspects of frailty were being assessed.
Methods
Patients with a suspected diagnosis of lung cancer discussed at the University Hospitals of Leicester Lung multidisciplinary team meeting (MDT) between January and December 2019 were reviewed. Electronic notes, MDT minutes and letters were interrogated. The populations aged over 65 and less than 65 years were compared.
Results
846 patients were discussed at Lung MDT. 80% were aged over 65 years and where performance status was (PS) recorded; 35% were PS 0-1, 12% were 2, 28% were 3-4. In the under 65s; 46% were PS 0-1, 10% were 2, 10% were 3-4. The over 65s had a similar incidence of lung cancer symptoms compared to under 65s respectively: dyspnoea (34% vs 33%), cough (27% vs 28%), pain (15% vs 20%) The over 65s had a lower rate of independence with activities of daily living (ADLs) compared to the under 65s (54% vs 71%) and assistance with basic ADLs was higher (10% vs 5%). The number of patients with unassisted mobility was lower in the over 65s (48% vs 66%). In the over 65s, 22% received Systemic Anticancer Treatment (SACT) compared to 8% in the under 65s. There were similar rates of non-completion of treatment respectively (55% vs 54%) and number of dose reductions (18% vs 15%). 35% of the over 65s and 46% in under 65s received immunotherapy. In the older population receiving immunotherapy, 30% had monotherapy were received, compared to 70% receiving chemo-immunotherapy. In the younger population 17% received monotherapy and 83% received chemo-immunotherapy. 37% of the older patients having SACT were admitted with a median stay of 2 days (range 1-30) compared to 31% in the younger group, with a median stay of 1.5 days (range 1-2).
Conclusions
Most patients with suspected lung cancer were over the age of 65; a quarter had a poor PS at presentation. Fewer of the older patients were independent of ADLs or mobility. Older patients were more frequently admitted with SACT. Areas of frailty are not routinely addressed in this population and a frailty assessment and intervention may be beneficial in reducing toxicity and admission during SACT.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.