Department of Obstetrics, Gynecology and Urologic Sciences, Sapienza University, Rome, Italy.
Oncology. 2013;85(3):168-72. doi: 10.1159/000350859. Epub 2013 Aug 30.
The aim of this study was to determine the tolerability, safety and feasibility of chemotherapy in very elderly patients with gynecological cancers.
We included all patients ≥ 75 years of age affected by endometrial, ovarian or cervical cancer treated with neoadjuvant, adjuvant or palliative chemotherapy. Data regarding age, stage of the disease, comorbidities, performance status (PS), chemotherapy regimen and dosing, toxicity, treatment delay and dose adjustments were recorded.
Forty-nine patients were included in the study. Their median age was 77.5 years. The vast majority of patients (89.8%) presented with advanced neoplastic disease. Twenty-nine of the 49 patients were treated with full-dose chemotherapy; 41% were subjected to the weekly dose. One toxic death was recorded; grade 2 anemia was reported in 8 patients, and grade 2 and 3 neutropenia was recorded in 2 and 3 patients, respectively. Sixty-one percent of the patients completed the planned treatment.
Chemotherapy in very elderly patients is feasible with an acceptable toxicity profile. Careful evaluation of PS and assessment of physical and psychological health are necessary to predict tolerability of chemotherapy. A weekly schedule is better tolerated in this setting.
本研究旨在确定化疗在妇科癌症高龄患者中的耐受性、安全性和可行性。
我们纳入了所有年龄≥75 岁、接受新辅助化疗、辅助化疗或姑息化疗的子宫内膜癌、卵巢癌或宫颈癌患者。记录了年龄、疾病分期、合并症、体能状态(PS)、化疗方案和剂量、毒性、治疗延迟和剂量调整等数据。
本研究纳入了 49 例患者。其中位年龄为 77.5 岁。绝大多数患者(89.8%)为晚期肿瘤疾病。49 例患者中有 29 例接受了全剂量化疗;41%接受了每周剂量。1 例患者发生毒性死亡;8 例患者出现 2 级贫血,2 例和 3 例患者分别出现 2 级和 3 级中性粒细胞减少症。61%的患者完成了计划治疗。
在高龄患者中进行化疗是可行的,且具有可接受的毒性特征。需要仔细评估 PS,并评估身体和心理健康状况,以预测化疗的耐受性。在这种情况下,每周方案的耐受性更好。