OBJECTIVES: Pancreatic cancer is a lethal disease mostly affecting elderly people. Clinical trials on treatment contain disproportionately fewer elderly patients compared with everyday practice. This retrospective study evaluates differences in the rates of chemotherapy delivered and associated survival in different age groups. METHODS: Data were collected from the Cancer Information Resource Files on patients diagnosed with pancreatic cancer from 1993 to 2008. Patients were divided into 3 age groups, namely, A with younger than 50 years, B with 50 to 70 years old, and C with older than 70 years. RESULTS: Complete data were available on 16,694 patients. Forty-four percent were in group C.Chemotherapy was given to 38% of patients in group C versus 69% of patients in group A. A multivariate analysis revealed a similar chemotherapy benefit in all groups, as follows: group C (hazard ratio [HR], 0.51), group A (HR, 0.74), and group B (HR, 0.55). CONCLUSIONS: We found that elderly patients with pancreatic cancer receive treatment less frequently compared with younger patients. However, elderly patients receiving chemotherapy derive similar benefits. Randomized clinical trials are needed to evaluate pancreatic cancer treatment in the elderly patients, particularly given the increasing occurrence of pancreatic cancer in later life.
OBJECTIVES:Pancreatic cancer is a lethal disease mostly affecting elderly people. Clinical trials on treatment contain disproportionately fewer elderly patients compared with everyday practice. This retrospective study evaluates differences in the rates of chemotherapy delivered and associated survival in different age groups. METHODS: Data were collected from the Cancer Information Resource Files on patients diagnosed with pancreatic cancer from 1993 to 2008. Patients were divided into 3 age groups, namely, A with younger than 50 years, B with 50 to 70 years old, and C with older than 70 years. RESULTS: Complete data were available on 16,694 patients. Forty-four percent were in group C.Chemotherapy was given to 38% of patients in group C versus 69% of patients in group A. A multivariate analysis revealed a similar chemotherapy benefit in all groups, as follows: group C (hazard ratio [HR], 0.51), group A (HR, 0.74), and group B (HR, 0.55). CONCLUSIONS: We found that elderly patients with pancreatic cancer receive treatment less frequently compared with younger patients. However, elderly patients receiving chemotherapy derive similar benefits. Randomized clinical trials are needed to evaluate pancreatic cancer treatment in the elderly patients, particularly given the increasing occurrence of pancreatic cancer in later life.
Authors: Thomas J Hayman; Tobin Strom; Gregory M Springett; Lodovico Balducci; Sarah E Hoffe; Kenneth L Meredith; Pamela Hodul; Mokenge Malafa; Ravi Shridhar Journal: J Gastrointest Oncol Date: 2015-10