Abstract Introduction: To compare a novel carboplatin-gemcitabine (CG) schedule with gemcitabine (G) monochemotherapy in elderly patients with advanced NSCLC. Methods: The records of all the consecutive elderly patients referred to our Department of Oncology for advanced NSCLC were reviewed. Overall survival was the main outcome, time to progression, response rate and safety were the secondary end points. Results: Fifty patients (40 males and 10 females, mean age 75 years, range 68-87 years) were included into the analysis. 30 patients (60%) were treated with the CG and 20 (40%) with G. Median survival was 12.4 months for the entire population, and 14.9 and 5.3 months for CG and G(p=0.043) respectively. 7(14%) and 2(4%) partial regressions were observed in CG and G groups,(p=0.085), with a median time to progression of 5.1 months for the entire population, and 7.3 and 3.5 months for CG and G(p=0.237). Grade III neutropenia was observed in 8(16%) and 2(4%) patients treated with CG and G, respectively; grade IV neutropenia in 2(4%) and 2(4%) patients, grade III anemia in 2(4%) and 1(2%) patients, and grade III thrombocytopenia in 1(2) patient, respectively (p=0.527). Grade II fatigue was observed in 5(10%) and 2(4%) patients, grade III diarrhea in 3(6%) and 1(2%) patients treated with CG and G, respectively (p=0.722). Conclusions: Carboplatin-gemcitabine seems to be more effective that gemcitabine alone in elderly patients with advanced NSCLC, without any worsening of the safety profile. The data, extracted from an outcome analysis, confirm what has been observed in previous clinical trials.
Keywords: lung cancer; chemotherapy; carboplatin; gemcitabine

Abstract Background: The transition in oncology to electronic charting offers the potential to improve the quality of patient care and value of observational research. Data fields that are more complete, have common standards, and are searchable are critical to help meet these goals. As a key data field, and proof-of-concept we studied the additional gain in recorded stage and agreement in cancer staging by adding ‘missing’ stage information into an oncology practice’s electronic medical records (EMR) from a state cancer registry. Methods: In this observational study, patient records were matched and compared between a practice-based (EMR) database (Georgia Cancer Specialists [GCS]) and a state cancer registry (Georgia Comprehensive Cancer Registry [GCCR]). Impact on recorded cancer stage following a merge of the EMR and registry data was assessed. Eligible patients had ≥1 visit to any GCS practice site during the study period (1/1/2005-12/31/2008) and had a diagnosis of a primary, malignant solid neoplasm (except brain or spine). Results: The final sample included 38,248 patients from GCS files, with 13,486 matched to patients with a solid malignant tumor in the GCCR files. There were 3,424 (25%) patients without staging information prior to GCCR integration, which was reduced to 12% after GCCR integration - a relative gain of 52%. Differences between initial GCS stage and initial GCCR stage occurred in 45% of the sample, and varied by cancer type. Conclusions: Adding information from external data sources can help create more complete patient records. The concept is feasible and has the potential to improve data quality. Patient data collected in different systems for different reasons will often be discordant.
Keywords: integrating oncology practice; cancer registry; tumor staging information