The Clinical Characteristics and Prognosis of Elderly Patients with Lung Cancer Diagnosed in Daegu and Gyeongsangbukdo

대구 경북지역에서 진단된 노령자 폐암의 임상적 특징과 예후

  • Kim, Hyun Sook (Department of Internal Medicine, College of Medicine, Catholic University of Daegu) ;
  • Hyun, Dae Sung (Department of Internal Medicine, College of Medicine, Catholic University of Daegu) ;
  • Kim, Kyung Chan (Department of Internal Medicine, College of Medicine, Catholic University of Daegu) ;
  • Lee, Sang Chae (Department of Internal Medicine, College of Medicine, Catholic University of Daegu) ;
  • Jung, Tae Hoon (Department of Internal Medicine, College of Medicine, Kyungpook National University) ;
  • Park, Jae Yong (Department of Internal Medicine, College of Medicine, Kyungpook National University) ;
  • Kim, Chang Ho (Department of Internal Medicine, College of Medicine, Kyungpook National University) ;
  • Cha, Seung Ick (Department of Internal Medicine, College of Medicine, Kyungpook National University) ;
  • Lee, Kwan Ho (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Chung, Jin Hong (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Shin, Kyeong Cheol (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Jeon, Young June (Department of Internal Medicine, College of Medicine, Keimyung University) ;
  • Han, Seong Beom (Department of Internal Medicine, College of Medicine, Keimyung University) ;
  • Choi, Won Il (Department of Internal Medicine, College of Medicine, Keimyung University) ;
  • Kim, Yeun Jae (Department of Internal Medicine, College of Medicine, Daegu Fatima Hospital) ;
  • Chung, Chi Young (Department of Internal Medicine, College of Medicine, Daegu Fatima Hospital) ;
  • Lim, Geon Il (Department of Internal Medicine, College of Medicine, Soonchunhyang University)
  • 김현숙 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 현대성 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 김경찬 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 이상채 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 정태훈 (경북대학교 의과대학 내과학교실) ;
  • 박재용 (경북대학교 의과대학 내과학교실) ;
  • 김창호 (경북대학교 의과대학 내과학교실) ;
  • 차승익 (경북대학교 의과대학 내과학교실) ;
  • 이관호 (영남대학교 의과대학 내과학교실) ;
  • 정진홍 (영남대학교 의과대학 내과학교실) ;
  • 신경철 (영남대학교 의과대학 내과학교실) ;
  • 전영준 (계명대학교 의과대학 내과학교실) ;
  • 한승범 (계명대학교 의과대학 내과학교실) ;
  • 최원일 (계명대학교 의과대학 내과학교실) ;
  • 김연재 (대구파티마병원 내과) ;
  • 정치영 (대구파티마병원 내과) ;
  • 임건일 (순천향대학교 의과대학 구미병원 내과학교실)
  • Received : 2008.05.27
  • Accepted : 2008.07.04
  • Published : 2008.07.30

Abstract

Background: Lung cancer is the leading cause of cancer death in South Korea since the year 2000 and it is more common in elderly patients, with a peak incidence at around 70~80 years of age. However, these elderly patients receive treatment less often than do the younger patients because of organ dysfunction related to their age and their comorbidities, and they show poor tolerance to chemotherapy. The aims of this study were to analyze the clinical characteristics and treatment-related survival of elderly patients with lung cancer. Methods: In this retrospective study, we analyzed the clinical data of 706 lung cancer patients who were diagnosed at hospitals in Daegu and Gyeongsangbukdo from January 2005 to December 2005. We compared the clinical characteristics and outcomes of the patients who were aged 70 years and older (elderly patients) with those clinical characteristics and outcomes of the younger individuals. Results: The median age of the patients was 68 years (from 29 to 93) and the elderly patients were 38.7% (n=273) of all the study's patients. Squamous cell carcinoma was the most common type of lung cancer in both the elderly and younger patient groups. Elderly patients had more symptoms of dyspnea and chronic obstructive pulmonary disease (COPD) than the younger patients (p<0.001 and p<0.001, respectively). A good performance status (ECOG 0-1) was less common for the elderly patients (p<0.001). The median survival of the non-small cell lung cancer (NSCLC) patients was significantly higher in the younger patient group than in the elderly patient group (962 days vs 298 days, respectively, p=0.001). However, the median survival of the NSCLC patients who received any treatment showed no significant difference between the younger patient group and the elderly patient group (1,109 days vs 708 days, respectively, p=0.14). Conclusion: Our data showed that appropriate treatment for selected elderly patients improved the survival of patients with NSCLC. Therefore, elderly NSCLC patients with a good performance status should be encouraged to receive appropriate treatment.

연구배경: 폐암은 우리나라 암 사망원인 질환의 가장 높은 비율을 차지하는 질환으로 특히 노령 인구에서 증가하는 추세이다. 그러나 노령의 폐암 환자는 동반된 질환, 노령에 따른 장기 기능의 저하 등의 이유로 적절한 치료를 받지못하는 경우가 많다. 이에 70세 이상의 노령 폐암 환자의 임상적 특징과 치료에 따른 생존기간 등을 알아보고자 한다. 방 법: 2005년 1월부터 2005년 12월까지 대구, 경북 지역에 소재하고 있는 대학병원 및 종합병원(경북대학병원, 구미 순천향병원, 대구가톨릭대학병원, 대구파티마병원, 동산의료원, 영남대학병원)에서 세포학적 혹은 조직학적으로 원발성 폐암을 진단받은 706명의 환자들을 70세 이상 환자군과 70세 미만 환자군으로 나누어 후향적으로 연구하였다. 결 과: 전체 환자 중 70세 이상의 환자는273명(38.7%)이었다. 70세 이상의 환자는 70세 미만보다 호흡곤란의 증상이 많았으며(p<0.001), 만성폐쇄성폐질환의 빈도가 높았고(p<0.001), 활동도가 좋은 경우가 적었다(p<0.001). 비소세포폐암 환자의 중앙생존기간은 70세 미만의 환자와 70세 이상의 환자에서 유의한 차이를 보였지만(962일 vs 298일, p=0.001), 한 가지라도 치료를 받았던 환자들을 대상으로 했을 때는 두 군간에 의미 있는 차이가 없었다(1,109일 vs 708일, p=0.14). 결 론: 70세 이상의 비소세포폐암 환자에서 환자의 활동도 등을 고려하여 적극적인 치료를 시행하는 것이 바람직할 것으로 생각된다.

Keywords

References

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