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Multidisciplinary decision-making regarding chemotherapy for lung cancer patients-An age-based comparison
K J G Schulkes1, M E Hamaker1, J-W J Lammers2
1Department of Geriatric Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
European Journal of Cancer Care
|September 24, 2017
Summary
Lung cancer treatment decisions differ by age. Older patients (75+) received chemotherapy less often, while those 65-75 experienced more hospital admissions, suggesting potential frailty.
Area of Science:
- Oncology
- Geriatric Medicine
- Health Services Research
Background:
- Optimizing treatment decisions for elderly patients is a growing concern in oncology.
- Lung cancer management requires careful consideration of age-related factors and patient frailty.
Purpose of the Study:
- To analyze lung cancer treatment decisions and therapeutic courses across different age categories: under 65, 65-75, and 75 years and older.
- To identify age-specific variations in chemotherapy initiation, treatment adaptations, and unplanned hospital admissions.
Main Methods:
- Retrospective review of 349 lung cancer patients (median age 67.8) discussed at a multidisciplinary team meeting.
- Extraction of data on multidisciplinary decision-making and clinical course from medical records.
- Categorization of patients into age groups: <65, 65-75, and ≥75 years.
Main Results:
- Chemotherapy initiation was lower in patients ≥75 years (39%) compared to younger groups (80%).
- Treatment adaptations occurred in 58% of chemotherapy recipients, with higher rates in older groups (66% for 65-75 and ≥75 vs. 49% for <65).
- Unplanned hospital admissions were noted in 44% of chemotherapy patients, peaking in the 65-75 age group (52%).
Conclusions:
- Lung cancer treatment decision-making and clinical outcomes vary significantly by age.
- The 65-75 age group may exhibit greater frailty than typically assumed, warranting closer attention.
- Age and frailty are critical factors that necessitate greater consideration in clinical practice and treatment planning.
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