1. Chemotherapy Regimen in Nonagenarian Cancer Patients: A Bi-Institutional Experience
- Author
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Coralie Moncharmont, Nicolas Magné, Lionel Vedrine, Jean-Baptiste Guy, Yacine Merrouche, Sharif Kullab, Jane-Chloé Trone, Cyrus Chargari, Benoîte Méry, Julien Langrand-Escure, Pierre Annede, Romain Rivoirard, Alexander T. Falk, Pierre Fournel, and Guillaume Moriceau
- Subjects
Male ,0301 basic medicine ,medicine.medical_specialty ,Palliative care ,medicine.medical_treatment ,Disease-Free Survival ,Targeted therapy ,03 medical and health sciences ,0302 clinical medicine ,Neoplasms ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Drug Discovery ,medicine ,Homes for the Aged ,Humans ,Pharmacology (medical) ,Aged, 80 and over ,Pharmacology ,business.industry ,Medical record ,Palliative Care ,Chemoradiotherapy ,General Medicine ,Chemotherapy regimen ,Surgery ,Radiation therapy ,030104 developmental biology ,Infectious Diseases ,Oncology ,Tolerability ,030220 oncology & carcinogenesis ,Concomitant ,Female ,business ,Follow-Up Studies - Abstract
Background: The elderly population in Western countries is growing and constitutes a public health issue. Concomitantly, age-related diseases such as cancer increase. There are few data on the efficacy, tolerability and toxicity of specific anticancer therapy in the very elderly patients; therefore, their management is not standardized. Methods: In this bi-institutional study, we reviewed medical records of patients who received or continued specific anticancer therapy beyond the age of 90 years. Geriatric assessment was not reported for our patients. Twelve patients were enrolled. Their general health condition was good, and half of them were living in elderly institutions. Ten patients had a solid tumor and 2 were treated for hematological malignancies. Most were diagnosed with a locally advanced or metastatic disease, and the goal of treatment was curative for only 1 patient. Six patients received chemotherapy as first-line treatment, 4 patients received targeted therapy and 2 received concomitant chemoradiation. Four patients received a second-line treatment. Results: Despite a significant reduction in treatment posology in half of the patients, 8 acute grade 3/4 toxicities were reported and 2 patients died of treatment-related septic shock. Median duration of first-line treatment was 3.2 months, and progression-free survival ranged from 18 to 311 days. Overall survival ranged from 18 days to 11 years. Conclusion: Aging is a heterogeneous process, and management of elderly patients is a multidisciplinary approach. Geriatric assessment helps to identify older patients with a higher risk of morbidity/mortality and allows to assess the risks and benefits of specific anticancer therapy. The choice of treatment should be based primarily on the expected symptomatic benefit, and treatment should not compromise the quality of life.
- Published
- 2015
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