Safety of Adjuvant Oral Uracil-Tegafur Therapy in Older Patients With Resected Non-small Cell Lung Cancer.

Background/Aim: Oral uracil-tegafur (UFT) therapy as adjuvant chemotherapy (ACT) has demonstrated efficacy and is widely used for patients with completely resected early-stage non-small cell lung cancer (NSCLC). However, most previous clinical trials have enrolled patients aged ≤75 years, and evidence regarding the safety of UFT in older patients remains limited. This study aimed to evaluate the safety of adjuvant UFT therapy in older patients. Patients and Methods: We retrospectively analyzed 101 patients who underwent curative lung resection and were pathologically diagnosed with stage IA3 or IB NSCLC (TNM 8th edition) at our department between January 2017 and January 2023. Patients were stratified into older (aged ≥75 years) and younger (aged <75 years) groups, and the administration rate of UFT therapy was compared. Among patients who received UFT, dose, treatment duration, completion rate of 24 months, and incidence of adverse events were further evaluated. Results: The older group included 42 patients (42%). The UFT administration rate was 63% in the younger group and 62% in the older group, with no statistically significant difference. UFT dose, completion rate of 24 months, and incidence of adverse events in older patients appeared not to be inferior to those in younger patients. However, in the standard-dose group (400 mg daily), the older group tended to have a lower completion rate and a higher incidence of adverse events. Conclusion: Adjuvant UFT therapy was generally safe in patients aged ≥75 years. Nevertheless, dose adjustments may be necessary in older patients. In a super-aging society, these findings underscore the importance of considering not only chronological age but also each patient's overall condition when making decisions regarding adjuvant UFT therapy.