Treatment of cancer in the elderly

Fentiman, IS

doi:10.1038/bjc.1991.453

Cited by 24 publications

(5 citation statements)

References 22 publications

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“…The treatment of cancer in the elderly has provoked controversy (Fentiman, 1991). Nearly all of the studies reviewed here had an upper age limit, and there is no evidence as to the effect of patterns of organisation of care on survival rates specifically for the elderly.…”

Section: Effects Of Hospital and Protocolmentioning

confidence: 99%

Centralised treatment, entry to trials and survival

Stiller

1994

Br J Cancer

228

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S_.mary A review was carried out of the published literature on survival rates for cancer in relation to patterns of organisation of medical care, specifically treatment at specialist centres or at hospitals treating larger numbers of patients and treatment by protocol, usually within the context of a clinical trial. Centralised referral or entry to trials was frequently associated with a higher survival rate, particularly for the less common cancers, and was never found to be associated with a lower survival rate. Few (Chouillet et al., 1994). Analyses of survival in relation to organisational factors have yet to appear from either of these studies.Finally, for 1984 onwards two electronic databases, Medline and Embase, were searched on the Silver Platter Cancer CD. Tables I-XI contain 32 references included on Cancer CD and already known to the author before searching began. Of these, 14 (44%) could be retrieved by a search of medical subject headings (MESH) containing at least one of the terms survival, outcome, prognosis, mortality and at least one of hospitals, protocols, cancer care facilities, referral, health services. Four additional references not previously known were found in this search, making a total of 18 publications, and these accounted for 2.8% of the total of 649 references so indexed. Extending the search to other fields or by additional keywords increased the total number of references retrieved by a much greater proportion than it did the number of relevant publications found. This is a considerably worse result than that found by Silagy (1993)

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Section: Effects Of Hospital and Protocolmentioning

confidence: 99%

Centralised treatment, entry to trials and survival

Stiller

1994

Br J Cancer

228

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“…The knowledge that cancer affects predominantly older persons prompted new descriptive research on the treatment of cancer in older people 20,21 . A large number of studies have now examined the outcomes of surgery in older patients and have generally shown that older age is not in itself a sufficient basis for deciding against surgery 22–32 …”

Section: Discussionmentioning

confidence: 99%

Temporal and Regional Variability in the Surgical Treatment of Cancer Among Older People

Farrow

Hunt

Samet

1996

J American Geriatrics Society

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“…There has been a general tendency among physicians to consider that aged people always have poor tolerance to chemotherapy and, in consequence, many elderly patients with cancer have been undertreated for fear of excessive toxicity (1)(2)(3)(4). However, there is little evidence from clinical studies that they should be treated with lower dosages of antineoplastic agents than younger patients.…”

Section: Introductionmentioning

confidence: 98%

Cancer Chemotherapy in the Elderly

Sekine

Fukuda

Kunitoh

et al. 1998

Japanese Journal of Clinical Oncology

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As the geriatric population is growing, it is increasingly important to be familiar with chemotherapy for the elderly. Age-related changes in pharmacokinetics are documented for doxorubicin, etoposide, ifosfamide, daunorubicin, mitomycin, cisplatin and methotrexate. The hematological toxicity of most standard-dose chemotherapy is not affected by age in patients with normal organic functions and good performance status, although increased toxicity with aging is suggested in the use of actinomycin-D, etoposide, vinblastin, methotrexate, methyl-CCNU, doxorubicin and mitomycin, and in dose-intensive chemotherapy. Among non-hematological toxicities, only doxorubicin-induced cardiomyopathy and bleomycin-induced pulmonary toxicity are demonstrated to be accelerated in the elderly. There is no evidence that advanced age decreases the efficacy of chemotherapy for tumors, except for Hodgkin's disease and acute leukemia. These results suggest that advanced chronological age alone is not always associated with severe toxicity and poor prognosis, and that many elderly patients with cancer will benefit from chemotherapy. To answer questions regarding the optimal chemotherapy regimen, dose and intensity in this population, the influence of age should be analyzed in a multivariate approach in future studies.

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Treatment of cancer in the elderly

Cited by 24 publications

References 22 publications

Centralised treatment, entry to trials and survival

Centralised treatment, entry to trials and survival

Temporal and Regional Variability in the Surgical Treatment of Cancer Among Older People

Cancer Chemotherapy in the Elderly

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