UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Dipartimento di scienze dell'invecchiamento, neurologiche, ortopediche e della testa collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, sede di Roma, Largo A. Gemelli 8, 00168, Rome, Italy.
Aging Clin Exp Res. 2021 Oct;33(10):2831-2837. doi: 10.1007/s40520-021-01821-2. Epub 2021 Mar 11.
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.
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.
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).
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.
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.
在未来的一段时间内，最年长人群的数量将大幅增加，而癌症作为与衰老密切相关的疾病，将在他们中非常普遍。缺乏证据是管理最年长人群癌症的一个巨大问题，而且在未来几年将越来越突出。
我们旨在研究在 Fondazione Policlinico A. Gemelli IRCCS 放射肿瘤学系接受治疗的最年长人群癌症患者的特征。
我们进行了一项回顾性研究。主要结局是评估哪些人群特征可能影响肿瘤治疗的选择（具有根治性或非根治性意图）。
我们共确定了 348 名患者：140 名处于随访中；177 名正在接受治疗；31 名被认为不符合治疗条件。接受治疗的患者合并症指数较高（平均 Charlson 合并症指数为 5.4），且普遍存在多药治疗（平均用药数为 5.6 种）。超过一半（53.1%）的患者接受了根治性治疗。接受根治性治疗的患者年龄小 1 岁（87.1 岁 vs 88.1 岁），表现更好（ECOG 0.7 级 vs 1.3 级），且转移性肿瘤的患病率较低（6.4% vs 34.9%）；两组患者的合并症和药物使用无差异。
通常不在国际指南中考虑的最年长人群也接受了肿瘤疾病的治疗，且通常采用根治性意图。治疗似乎没有根据合并症进行调整，而是根据表现状态进行。
