Use of palliative chemotherapy in patients aged 80 years and over with incurable cancer: experience at three Sydney cancer centres

Ip, Emilia; Pokorny, Adrian M J; Della-Fiorentina, Stephen; Beale, Philip; Bray, Victoria; Kiely, Belinda E; Blinman, Prunella

doi:10.1111/imj.13296

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…A very reliable and positive data are, indeed, that only five patients interrupted the treatment, which means that 97% of patients completed the treatment. In several studies investigating the feasibility of chemotherapy in oldest old only 50% or less of patients could complete the chemotherapy planned [ 31 , 32 ]. This difference suggests that radiotherapy is a treatment that fits perfectly to elderly with better predictable effects and higher possibility to complete the planned treatment.…”

Section: Discussionmentioning

confidence: 99%

Perspectives and limits of cancer treatment in an oldest old population

et al. 2021

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Background Population of oldest old will grow dramatically in the next future and cancer, physiologically related to aging, will be very prevalent among them. Lack of evidence is a huge problem to manage cancer in oldest old and will be more and more in the next years. Aims Our purpose was to investigate the characteristics of a population of oldest old patients with cancer treated in the Radiation Oncology Unit of Fondazione Policlinico A. Gemelli IRCCS. Methods We conducted a retrospective study. The primary outcome was to evaluate which characteristics of the population could influence the choice of oncological treatment (with radical or non-radical intent). Results We identified a total of 348 patients: 140 were on follow-up; 177 were under treatment; 31 were considered not eligible for treatments. Patients under treatment had a high comorbidity index (mean Charlson Comorbidity Index 5.4), and a high prevalence of polypharmacy (mean number of drugs 5.6). More than half (53.1%) was treated with radical intent. Patients treated with radical intent were 1 year younger (87.1 years old vs 88.1 years old), more performant (ECOG 0.7 vs 1.3), and had less prevalence of metastatic neoplasia (6.4% vs 34.9%); comorbidities and drugs did not show differences in the two groups. Conclusion Oldest old, usually not considered in international guidelines, are treated for oncological disease, often with radical intent. The treatment seems not to be tailored considering comorbidities but on performance status.

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Section: Discussionmentioning

confidence: 99%

Perspectives and limits of cancer treatment in an oldest old population

et al. 2021

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“…13 Bias on the basis of age can also lead to failure to offer options, such as the use of palliative chemotherapy even though the adverse effects versus benefits may be acceptable and even desired by an elderly woman with cancer. 14 For cancer care in general, avoiding pain and alleviating major symptom groups, such as gastrointestinal distress and neuropathic symptoms, is virtually universal. The meaning attached to where that care is given and where someone might die may be culturally and generationally nuanced, but even within cultures and age groups it varies by individual and context.…”

Section: The Central Role Of Communicationmentioning

confidence: 99%

Palliative care in women's cancer care: Global challenges and advances

Cain

Denny

2018

Intl J Gynecology & Obste

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Women's cancer rates are increasing in low‐ and middle‐income countries, with presentations that are often far advanced requiring intense symptom management, thus advancing the urgent need to address palliative care. Most resource settings have some options available to assist women with advanced gynecologic cancer, and a combination of leveraging these and expanding on emerging models for palliative care could lessen suffering and improve care for women with gynecologic cancers globally. Providing palliative care for women with cancer is constrained by resources (human and physical), lack of equipment, lack of access, and policy absence or barriers. There is important work to be done in advocating for appropriate infrastructure development and legislation to assure that these options are available to women and their families. Access to adequate opioid and other pain relief options for cancer‐related pain is a particular concern given that availability, cost, and legislative prohibitions create barriers that cause suffering for patients and grief for their families who are unable to address their suffering. All of these require ongoing advocacy for continual advances to improve access and infrastructure for palliative care.

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“…Estudo com pacientes muito idosos para tratar câncer colorretal (Ip, 2017;Fakhry, et al, 2013;Hayashi, et al, 2017;Laribi, et al, 2016;Park, et al, 2016;Rinaldi, et al, 2017;Tokushige, Hashimoto, Horie, Taniai, & Higuchi, 2014;e Varga, et al, 2014). Esses dados justificam, em parte, os achados no que diz respeito aos estudos sobre intervenção medicamentosa, tendo em vista que, em sua maioria, tratavam-se de quimioterápicos (Ip, 2017;Hayashi, et al, 2017;Laribi, et al, 2016).…”

Section: Digestive and Liver Diseaseunclassified

Idosos mais idosos: uma revisão da literatura

et al. 2019

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O objetivo é revisar os artigos científicos publicados nos últimos cinco anos sobre idosos longevos (≥80 anos) e identificar o perfil dessas publicações. Foi realizada uma revisão da literatura, utilizando-se a Biblioteca Virtual em Saúde. A busca resultou na seleção de 36 artigos nacionais e internacionais. Observou-se que a maioria dos estudos era do tipo transversal, realizados em países da Europa e com maior participação de idosos do sexo feminino. Câncer e doenças cardíacas foram os temas mais abordados.

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Use of palliative chemotherapy in patients aged 80 years and over with incurable cancer: experience at three Sydney cancer centres

Cited by 6 publications

References 21 publications

Perspectives and limits of cancer treatment in an oldest old population

Perspectives and limits of cancer treatment in an oldest old population

Palliative care in women's cancer care: Global challenges and advances

Idosos mais idosos: uma revisão da literatura

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