Document Detail


Systemic Treatment of Gastrointestinal Cancer in Elderly Patients.
MedLine Citation:
PMID:  23150086     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Gastrointestinal cancer (GI) incidence increases with each decade of life and is the leading cause of death in patients aged >70 years. Nevertheless, elderly patients are often excluded or underrepresented in clinical trials. We performed a review of current recommendations in the management of GI elderly cancer patients. METHODS: A comprehensive literature review was performed analyzing data about several meta-analysis and studies regarding chemotherapeutic regimens in elderly patients with colorectal and gastroesophageal cancers. RESULTS: Most of the studies demonstrated that the elderly experience the same advantages and toxicities from chemotherapy as younger individuals despite the fact that the data reviewed in this article provide evidence that elderly with GI cancers are underrepresented in clinical trials and few trials are conducted addressing the different risks and aims in older population. Each individual should be assessed for an appropriate regimen of treatment in the adjuvant or metastatic gastrointestinal cancer setting, and the decision of how to treat elderly must incorporate goals and preferences of the patient after a careful discussion of risks and benefits. CONCLUSION: Chronological age alone is not a sufficient factor to withhold curative/palliative treatment from an elderly GI cancer patient, and cofactors regarding their functional, social, and mental status have to be considered. For this purpose, several tools exist that may be utilized, such as geriatric assessment scores, comorbidity indices, frailty indices, scores for predicting toxicity from chemotherapy, and prognostic indices for survival.
Authors:
Silvana Leo; Caterina Accettura; Antonio Gnoni; Antonella Licchetta; Marianna Giampaglia; Annamaria Mauro; Valeria Saracino; Brian I Carr
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-14
Journal Detail:
Title:  Journal of gastrointestinal cancer     Volume:  -     ISSN:  1941-6636     ISO Abbreviation:  J Gastrointest Cancer     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479627     Medline TA:  J Gastrointest Cancer     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Geriatric Oncology Unit-Medical Oncology Department, Vito Fazzi Hospital, Lecce, Italy, silvileo@libero.it.
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