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Cancer chemotherapy in the elderly

I Sekine1, H Fukuda, H Kunitoh

  • 1Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan. isekine@gan2.ncc.go.jp

Japanese Journal of Clinical Oncology
|October 14, 1998
PubMed
Summary

Chemotherapy for elderly cancer patients shows that age doesn't always mean more toxicity or worse outcomes. Many older adults can benefit from chemotherapy, with specific drug toxicities and efficacy varying by age.

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Area of Science:

  • Geriatric Oncology
  • Pharmacology
  • Clinical Medicine

Background:

  • The growing geriatric population necessitates understanding chemotherapy's impact on older adults.
  • Age-related pharmacokinetic changes are noted for several chemotherapy agents.

Purpose of the Study:

  • To review the effects of age on chemotherapy toxicity and efficacy in elderly cancer patients.
  • To identify chemotherapy agents and regimens where age influences outcomes.

Main Methods:

  • Review of documented age-related pharmacokinetic changes.
  • Analysis of hematological and non-hematological toxicities in relation to age.
  • Evaluation of chemotherapy efficacy in elderly populations.

Main Results:

  • Hematological toxicity is generally unaffected by age in patients with good performance status, though some agents may increase toxicity.
  • Non-hematological toxicities like doxorubicin cardiomyopathy and bleomycin pulmonary toxicity are accelerated in the elderly.
  • Chemotherapy efficacy is not decreased by advanced age, except in Hodgkin's disease and acute leukemia.

Conclusions:

  • Advanced chronological age alone does not invariably lead to severe toxicity or poor prognosis.
  • Many elderly cancer patients can benefit from chemotherapy.
  • Future studies should use multivariate analysis to determine optimal chemotherapy regimens for the elderly.

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