Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age
| Autor: | Flavia Foca, Giacomo Miserocchi, Alberto Bongiovanni, Federica Recine, Stefano Severi, Nada Riva, Chiara Liverani, Greta Fabbri, Dino Amadori, Laura Mercatali, Chiara Spadazzi, Alessandro De Vita, Valentina Fausti, Toni Ibrahim |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Neuroendocrine tumors elderly patients lcsh:Diseases of the endocrine glands. Clinical endocrinology Gastroenterology 03 medical and health sciences 0302 clinical medicine Endocrinology Internal medicine Internal Medicine medicine Neuroendocrine neoplasia Chemotherapy lcsh:RC648-665 Performance status Proportional hazards model business.industry Research Incidence (epidemiology) neuroendocrine carcinoma medicine.disease Clinical trial 030220 oncology & carcinogenesis Radionuclide therapy neuroendocrine tumors business neuroendocrine neoplasia |
| Zdroj: | Endocrine Connections Endocrine Connections, Vol 7, Iss 12, Pp 1535-1541 (2018) |
| ISSN: | 2049-3614 |
| Popis: | The incidence of neuroendocrine neoplasia (NEN) is higher in individuals ≥70 years of age (elderly) who are underrepresented in clinical trials because of comorbidities and low performance status. We retrospectively analyzed the outcome of elderly patients with metastatic NEN (mNEN). Comorbidities were summarized by Charlson Comorbidity Index (CCI), Kaplan–Meier method was applied to estimate overall survival (OS) and Cox’s proportional hazard model was used to assess the impact of known prognostic factors. We retrieved data on 145 mNEN patients aged ≥70 years seen at our center from June 2007 to March 2016. Fifty-six (38.6%) were aged ≥75 years. ECOG PS was 0 in 45.7% of cases and CCI was 0 in 41.0% and 1 in 37.4%. A total of 75.4% of patients had grade (G)1/G2 NEN and 24.6%, G3. Octreoscan/Gallium PET/CT and FDG-PET/CT were positive in 94.2% and 70.3% of cases, respectively. Median follow-up was 72.3 (53.2–85.1) months. Seventy-nine patients received first-line somatostatin analogs (SSA), 23 peptide receptor radionuclide therapy (PRRT) and 36 chemotherapy (CHT). Seven did not undergo first-line therapy and 102 received more than one line. Median overall survival (mOS) was 5.1 years (95% CI: 3.4–6.6). No differences in mOS were seen according to CCI. First-line PRRT patients had a mOS of 6.5 years (95% CI: 3.3–not reached (NR)), SSA 5.7 years (95% CI: 4.2–7) and CHT 5.9 years (95% CI: 0.4–NR). mOS in CHT-treated G3 patients was 1.5 years (1.0–2.5). ECOG PS and FDG PET/CT were identified as independent prognostic factors. Results suggest that the above treatments positively impacted OS in elderly mNEN patients, including those aged ≥75 years. |
| Databáze: | OpenAIRE |
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