Perspectives and limits of cancer treatment in an oldest old population.
Cancer
Elderly
Geriatric oncology
Oldest old
Personalized medicine
Radiation oncology
Journal
Aging clinical and experimental research
ISSN: 1720-8319
Titre abrégé: Aging Clin Exp Res
Pays: Germany
ID NLM: 101132995
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
19
11
2020
accepted:
17
02
2021
pubmed:
12
3
2021
medline:
26
10
2021
entrez:
11
3
2021
Statut:
ppublish
Résumé
Population of oldest old will grow dramatically in the next future and cancer, physiologically related to aging, will be very prevalent among them. Lack of evidence is a huge problem to manage cancer in oldest old and will be more and more in the next years. Our purpose was to investigate the characteristics of a population of oldest old patients with cancer treated in the Radiation Oncology Unit of Fondazione Policlinico A. Gemelli IRCCS. We conducted a retrospective study. The primary outcome was to evaluate which characteristics of the population could influence the choice of oncological treatment (with radical or non-radical intent). We identified a total of 348 patients: 140 were on follow-up; 177 were under treatment; 31 were considered not eligible for treatments. Patients under treatment had a high comorbidity index (mean Charlson Comorbidity Index 5.4), and a high prevalence of polypharmacy (mean number of drugs 5.6). More than half (53.1%) was treated with radical intent. Patients treated with radical intent were 1 year younger (87.1 years old vs 88.1 years old), more performant (ECOG 0.7 vs 1.3), and had less prevalence of metastatic neoplasia (6.4% vs 34.9%); comorbidities and drugs did not show differences in the two groups. Oldest old, usually not considered in international guidelines, are treated for oncological disease, often with radical intent. The treatment seems not to be tailored considering comorbidities but on performance status.
Sections du résumé
BACKGROUND
BACKGROUND
Population of oldest old will grow dramatically in the next future and cancer, physiologically related to aging, will be very prevalent among them. Lack of evidence is a huge problem to manage cancer in oldest old and will be more and more in the next years.
AIMS
OBJECTIVE
Our purpose was to investigate the characteristics of a population of oldest old patients with cancer treated in the Radiation Oncology Unit of Fondazione Policlinico A. Gemelli IRCCS.
METHODS
METHODS
We conducted a retrospective study. The primary outcome was to evaluate which characteristics of the population could influence the choice of oncological treatment (with radical or non-radical intent).
RESULTS
RESULTS
We identified a total of 348 patients: 140 were on follow-up; 177 were under treatment; 31 were considered not eligible for treatments. Patients under treatment had a high comorbidity index (mean Charlson Comorbidity Index 5.4), and a high prevalence of polypharmacy (mean number of drugs 5.6). More than half (53.1%) was treated with radical intent. Patients treated with radical intent were 1 year younger (87.1 years old vs 88.1 years old), more performant (ECOG 0.7 vs 1.3), and had less prevalence of metastatic neoplasia (6.4% vs 34.9%); comorbidities and drugs did not show differences in the two groups.
CONCLUSION
CONCLUSIONS
Oldest old, usually not considered in international guidelines, are treated for oncological disease, often with radical intent. The treatment seems not to be tailored considering comorbidities but on performance status.
Identifiants
pubmed: 33704699
doi: 10.1007/s40520-021-01821-2
pii: 10.1007/s40520-021-01821-2
pmc: PMC8531055
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2831-2837Informations de copyright
© 2021. The Author(s).
Références
JAMA. 2013 Nov 6;310(17):1795-6
pubmed: 24193075
Front Public Health. 2017 Dec 11;5:335
pubmed: 29312916
J Urol. 2009 May;181(5):1998-2006; discussion 2007-8
pubmed: 19286225
Phys Ther. 2017 Sep 1;97(9):904-914
pubmed: 28969348
Biomed Res Int. 2018 Jan 21;2018:2178469
pubmed: 29581964
Aging Dis. 2020 May 9;11(3):649-657
pubmed: 32489709
Expert Rev Anticancer Ther. 2018 Nov;18(11):1101-1112
pubmed: 30188738
Eur J Cancer Care (Engl). 2019 Jul;28(4):e13049
pubmed: 31033091
J Gynecol Oncol. 2020 Jan;31(1):e6
pubmed: 31788996
J Gerontol A Biol Sci Med Sci. 2014 Apr;69(4):430-7
pubmed: 23913935
Clin Endocrinol (Oxf). 2016 Nov;85(5):689-693
pubmed: 27497423
J Geriatr Oncol. 2019 Jan;10(1):4-30
pubmed: 30017734
JAMA. 2018 Oct 16;320(15):1535-1536
pubmed: 30326521
Clin Drug Investig. 2016 Feb;36(2):109-18
pubmed: 26619839
J Oncol. 2020 Feb 28;2020:3928976
pubmed: 32190051
J Contemp Brachytherapy. 2017 Dec;9(6):497-498
pubmed: 29441092
BMC Res Notes. 2014 Jun 05;7:340
pubmed: 24897943
J Clin Oncol. 2019 Jun 20;37(18):1519-1523
pubmed: 30995173
J Geriatr Oncol. 2019 May;10(3):514-517
pubmed: 30314955
Biomed Res Int. 2018 Jan 17;2018:6074808
pubmed: 29581979
Clin Ther. 2017 May;39(5):884-893
pubmed: 28431765
Cancer. 2012 Mar 1;118(5):1371-86
pubmed: 21953606
Cancer J. 2017 Jul/Aug;23(4):223-230
pubmed: 28731945
Tumori. 2021 Feb;107(1):26-31
pubmed: 32410505
Lancet Oncol. 2012 Apr;13(4):e148-60
pubmed: 22469125
CA Cancer J Clin. 2019 Nov;69(6):452-467
pubmed: 31390062
Surg Clin North Am. 2018 Aug;98(4):819-833
pubmed: 30005776
Int J Urol. 2018 Jan;25(1):45-53
pubmed: 29052905
PLoS One. 2015 Nov 10;10(11):e0142123
pubmed: 26554710
Breast Cancer Res Treat. 2018 Apr;168(2):299-310
pubmed: 29264751
Intern Med J. 2017 Jan;47(1):75-81
pubmed: 27749003
J Clin Oncol. 2014 Aug 20;32(24):2604-10
pubmed: 25071126
Aging Dis. 2017 Oct 1;8(5):677-684
pubmed: 28966809