Treatment Intensity, not Age, Affects Survival Time of Patients with Advanced Pancreatic Cancer.
Journal
Journal of gastrointestinal and liver diseases : JGLD
ISSN: 1842-1121
Titre abrégé: J Gastrointestin Liver Dis
Pays: Romania
ID NLM: 101272825
Informations de publication
Date de publication:
21 09 2021
21 09 2021
Historique:
pubmed:
11
8
2021
medline:
3
3
2022
entrez:
10
8
2021
Statut:
epublish
Résumé
Despite older-aged individuals accounting for most patients with pancreatic cancer, elderly patients are still underrepresented in the clinical trials. Our study aims to identify treatment differences as well as to analyze survival times in the younger and older patient group. We evaluated the data of 97 pancreatic cancer patients (72 <75 years; 25 ≥75 years) receiving palliative chemotherapy. Age, comorbidity, body mass index (BMI), tumor localization, metastases, carbohydrate-antigen 19-9 (CA19-9) value, number and type of chemotherapeutic agents and treatment regimens used, treatment lines, toxicity and survival time were assessed. The age groups did not differ in their initial conditions (comorbidity, BMI, tumor characteristics). However, treatment intensity of patients ≥ 75 years was lower. Elderly patients received significantly fewer different chemotherapeutic agents and therapeutic regimens, therapy lines and fewer combination chemotherapies. Moreover, elderly patients survived significantly shorter (7.6 vs. 12.7 months, p=0.001). In multivariance analysis, a significant negative influence on survival time was revealed for low therapy intensity (≤2 chemotherapeutics, ≤2 therapy lines), but not for age. In addition, therapy discontinuation and underweight were significantly associated with survival time. Not age per se but lower therapy intensity leads to a shorter overall survival in the elderly patient group.
Sections du résumé
BACKGROUND AND AIMS
Despite older-aged individuals accounting for most patients with pancreatic cancer, elderly patients are still underrepresented in the clinical trials. Our study aims to identify treatment differences as well as to analyze survival times in the younger and older patient group.
METHODS
We evaluated the data of 97 pancreatic cancer patients (72 <75 years; 25 ≥75 years) receiving palliative chemotherapy. Age, comorbidity, body mass index (BMI), tumor localization, metastases, carbohydrate-antigen 19-9 (CA19-9) value, number and type of chemotherapeutic agents and treatment regimens used, treatment lines, toxicity and survival time were assessed.
RESULTS
The age groups did not differ in their initial conditions (comorbidity, BMI, tumor characteristics). However, treatment intensity of patients ≥ 75 years was lower. Elderly patients received significantly fewer different chemotherapeutic agents and therapeutic regimens, therapy lines and fewer combination chemotherapies. Moreover, elderly patients survived significantly shorter (7.6 vs. 12.7 months, p=0.001). In multivariance analysis, a significant negative influence on survival time was revealed for low therapy intensity (≤2 chemotherapeutics, ≤2 therapy lines), but not for age. In addition, therapy discontinuation and underweight were significantly associated with survival time.
CONCLUSION
Not age per se but lower therapy intensity leads to a shorter overall survival in the elderly patient group.
Substances chimiques
Antineoplastic Agents
0
CA-19-9 Antigen
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM