Chemotherapy in the oldest old: Choices and outcomes.
Autor: | van Walree IC; Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands., van Breukelen ELG; University Medical Centre Utrecht, Utrecht, The Netherlands., Thielen N; Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands., van Rens MTM; Department of Pulmonology, Diakonessenhuis, Utrecht, The Netherlands., van Huis-Tanja LH; Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands., Hamaker ME; Department of Geriatric Medicine, Diakonessenhuis, Utrecht, The Netherlands. |
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Jazyk: | angličtina |
Zdroj: | European journal of cancer care [Eur J Cancer Care (Engl)] 2019 Jul; Vol. 28 (4), pp. e13049. Date of Electronic Publication: 2019 Apr 29. |
DOI: | 10.1111/ecc.13049 |
Abstrakt: | Treatment decision-making in older patients with cancer is difficult due to a paucity of data evaluating chemotherapy tolerability in this population. We investigated the feasibility of chemotherapy in the oldest old and performed a singl-centre retrospective analysis of patients aged ≥80 years initiating chemotherapy for one of five common solid malignancies or non-Hodgkin lymphoma between 2010 and 2016. Treatment plan and course were extracted from medical files. Primary outcome was whether chemotherapy was completed according to plan, defined as a calculated relative dose intensity (RDI) ≥85%. A total of 104 patients receiving 129 chemotherapy lines were included. Median age at diagnosis was 82 years (range 80-94 years). Most patients (64%) received palliative intent chemotherapy. Primary and secondary chemotherapy adaptations were implemented in 63% and 65% of the cases, and hospitalisation occurred in a quarter. 52% of all cases completed chemotherapy according to plan. Almost half of the chemotherapy regimens started in the oldest old were not completed according to plan, despite frequently implemented upfront adaptations. The decision to start chemotherapy in these patients should be carefully considered. To improve decision-making in current practice, there is a need for the implementation of validated tools assessing chemotherapy feasibility in these patients. (© 2019 John Wiley & Sons Ltd.) |
Databáze: | MEDLINE |
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