Tolerance to chemotherapy in elderly patients with cancer.
Open Access
- 1 January 2007
- journal article
- review article
- Published by SAGE Publications in Cancer Control
- Vol. 14 (1), 44-56
- https://doi.org/10.1177/107327480701400106
Abstract
Background Due to demographic changes, the number of elderly people with cancer will increase in the next decades. In the past, elderly patients with cancer were often excluded from clinical trials. Chronological age has been considered a risk factor for increased toxicity and reduced tolerance to chemotherapy. Methods We present a review on toxicity of chemotherapy and factors associated with toxicity in elderly patients with cancer, and we discuss chemotherapeutic agents and treatment options in treating this patient population. Results Age is a risk factor for increased toxicity to chemotherapy and decreased tolerance. However, few trials have been reported with adjustment for age-associated changes such as impairment of functional status and increased comorbidity, which also show an independent association with increased toxicity. Published data may include several biases, such as referral and publication bias. Conclusions Decision making in elderly cancer patients should be based on the results of a geriatric assessment. Patients with few or no limitations should be treated as younger patients are treated. Data with a high level of evidence are unavailable for patients showing moderate or severe limitations in a geriatric assessment.Keywords
This publication has 99 references indexed in Scilit:
- Impairment in functional status and survival in patients with acute myeloid leukaemiaZeitschrift für Krebsforschung und Klinische Onkologie, 2006
- Efficacy and tolerability of chemotherapy in elderly patients with advanced oesophago-gastric cancer: A pooled analysis of three clinical trialsEuropean Journal Of Cancer, 2006
- Pharmacokinetics of oxaliplatin and non-hematological toxicity in metastatic gastrointestinal cancer patients treated with chronomodulated oxaliplatin, 5-FU and sodium folinate in a pilot investigatInternational journal of clinical pharmacology and therapeutics, 2006
- Cardiovascular toxicity is increased, but manageable, during high-dose chemotherapy and autologous peripheral blood stem cell transplantation for patients aged 60 years and olderLeukemia & Lymphoma, 2005
- Patterns of toxicity in older patients with breast cancer receiving adjuvant chemotherapyBreast Cancer Research and Treatment, 2005
- Adjuvant chemotherapy for elderly patients (≥70 years) with early high-risk breast cancer: a retrospective analysis of 260 patientsAnnals Of Oncology, 2005
- Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trialsThe Lancet, 2005
- EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancerEuropean Journal Of Cancer, 2004
- Prognostic factors in patients with metastatic colorectal cancer receiving 5-fluorouracil and folinic acidEuropean Journal Of Cancer, 1992
- Prediction of Creatinine Clearance from Serum CreatinineNephron, 1976