Literature DB >> 12569613

Can older cancer patients tolerate chemotherapy? A prospective pilot study.

Hongbin Chen1, Alan Cantor, Julie Meyer, Mary Beth Corcoran, Edward Grendys, Denise Cavanaugh, Shirley Antonek, Angela Camarata, William Haley, Lodovico Balducci, Martine Extermann.   

Abstract

BACKGROUND: To the authors' knowledge, few data currently are available regarding the tolerance to chemotherapy in older cancer patients. This prospective pilot study evaluated the changes in functional, mental, nutritional, and comorbid status, as well as the quality of life (QOL), in geriatric oncology patients receiving chemotherapy.
METHODS: Sixty patients age > or = 70 years who were undergoing cancer chemotherapy were recruited in a university-based comprehensive cancer center. Changes in physical function were measured by the Eastern Cooperative Oncology Group performance status (ECOG PS) and Instrumental Activities of Daily Living (IADLs), mental health changes were measured by the Mini-Mental State Examination and the Geriatric Depression Scale (GDS), comorbidity was measured by Charlson's index and the Cumulative Illness Rating Scale-Geriatric, nutrition was measured by the Mini-Nutritional Assessment, and QOL was measured by the Functional Assessment of Cancer Therapy-General (FACT-G). Changes were assessed at baseline and at the end of treatment (EOT). Grade 4 hematologic and Grade 3-4 nonhematologic toxicities were recorded.
RESULTS: Thirty-seven patients (63%) completed both assessments. Older cancer patients demonstrated a significant decline in measurements of physical function after receiving chemotherapy, as indicated by changes in scores on the IADL (P = 0.04) and on the physical (P = 0.01) and functional (P = 0.03) subscales of the FACT-G. They also displayed worse scores on the GDS administered postchemotherapy (P < 0.01). Patients who experienced severe chemotoxicity had more significant declines in ECOG PS (P = 0.03), IADL (P = 0.03), and GDS (P = 0.04), and more gain in the social well-being subscale (P = 0.02) of the FACT-G, than those who did not experience severe chemotoxicity. However, changes in most scores were small in magnitude clinically. No significant change was found between baseline and EOT in nutrition, comorbidity, and other aspects of the FACT-G.
CONCLUSIONS: Older cancer patients undergoing chemotherapy may experience toxicity but generally can tolerate it with limited impact on independence, comorbidity, and QOL levels. It is important to recognize and monitor these changes during geriatric oncology treatment. Copyright 2003 American Cancer Society

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Year:  2003        PMID: 12569613     DOI: 10.1002/cncr.11110

Source DB:  PubMed          Journal:  Cancer        ISSN: 0008-543X            Impact factor:   6.860


  41 in total

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3.  A prospective analysis of the influence of older age on physician and patient decision-making when considering enrollment in breast cancer clinical trials (SWOG S0316).

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Review 6.  Older adults and cancer treatment.

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Journal:  Cancer       Date:  2008-12-15       Impact factor: 6.860

7.  Polypharmacy, Inappropriate Medication Use, and Drug Interactions in Older Korean Patients with Cancer Receiving First-Line Palliative Chemotherapy.

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Journal:  Oncologist       Date:  2019-11-27

Review 8.  An update on cancer- and chemotherapy-related cognitive dysfunction: current status.

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Journal:  Semin Oncol       Date:  2011-06       Impact factor: 4.929

9.  Age disparity in the dissemination of imatinib for treating chronic myeloid leukemia.

Authors:  Charles L Wiggins; Linda C Harlan; Harold E Nelson; Jennifer L Stevens; Cheryl L Willman; Edward N Libby; Robert A Hromas
Journal:  Am J Med       Date:  2010-08       Impact factor: 4.965

10.  Geriatric oncology: an overview of progresses and challenges.

Authors:  Martine Extermann
Journal:  Cancer Res Treat       Date:  2010-06-30       Impact factor: 4.679

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