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[Chemotherapy in elderly patients with bronchogenic cancers]
P J Souquet1, C H Lombard-Bohas, G Freyer
1Service de Pneumologie, CH Lyon Sud, Pierre-Bénite.
Revue Des Maladies Respiratoires
|January 1, 1996
Summary
Older patients with bronchogenic carcinoma receive less intensive cancer therapies, despite a lack of scientific justification. Age-related toxicities from treatments like cisplatinum are more pronounced in elderly individuals, particularly neurological and digestive effects.
Area of Science:
- Oncology
- Geriatric Medicine
- Pulmonology
Background:
- Bronchogenic carcinoma disproportionately affects older males.
- Current treatment disparities exist for patients over 70-75 years old.
- Existing studies supporting these disparities often suffer from retrospective design and selection bias.
Purpose of the Study:
- To critically evaluate the scientific basis for differential treatment intensity in older patients with bronchogenic carcinoma.
- To analyze the age-related toxicity profiles of common cancer therapies, specifically cisplatinum.
Main Methods:
- Review of existing literature on bronchogenic carcinoma treatment in elderly patients.
- Analysis of retrospective studies and their inherent biases.
- Examination of cisplatinum-related toxicities (nephrotoxicity, neurological, digestive, medullary) in different age groups.
Main Results:
- Treatment intensity is often reduced for patients over 70-75 years.
- Retrospective studies exhibit significant selection bias, questioning their validity.
- Nephrotoxicity from cisplatinum does not appear to be significantly higher in older patients.
- Neurological, digestive, and medullary toxicities are more pronounced in older individuals.
Conclusions:
- The current practice of undertreating elderly patients with bronchogenic carcinoma lacks robust scientific evidence.
- Age-based treatment decisions should consider potential increased toxicities in older adults, particularly neurological, digestive, and medullary effects.
- Further prospective research is needed to establish evidence-based treatment guidelines for geriatric oncology patients.