Oytun Merve Güner, Bulut Gülcan, Gökmen Erhan, Doğu Burcu B, Karabulut Bülent
Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
Division of Medical Oncology, Department of Internal Medicine, Ege University School of Medicine, Izmir, Turkey.
J Oncol Pharm Pract. 2022 Apr;28(3):569-576. doi: 10.1177/10781552211002912. Epub 2021 Mar 22.
Decision- making of the treatment of colon cancer for the older patients becomes more complicated in consequence of comorbidities and geriatric syndromes, most importantly frailty. In the present study, we aimed to investigate whether there is a difference between tumour characteristics, treatment choices, and outcomes between the younger and older adults.
The patients who were diagnosed with colorectal carcinoma in our centre between 2010 and 2015 included. Clinicopathological features of tumour, treatment choices and survivals of the patients were recorded. Patients were separated into two groups according to their chronological age.
The present study included 465 patients, there were 173 patients aged 65 years and older. Clinicopathological features were similar in both groups. Adjuvant chemotherapy was given in similar rates. Whereas combination chemotherapies were preferred in younger patients as first-line therapy, single agents were given to the older group(p-value < 0.001). No significant differences were observed between combination therapy and monotherapy as progression-free and overall survival in older adults(p value > 0.05). It was observed that 53.2% of the older patients was not treated with any biological treatment (p-value < 0.001).
Geriatric people are underrepresented in clinical trials,because of the presence of the limitations in the older patients. The results of our study revealed older patients with colon cancer patients underwent surgery less than the younger ones, they recieved monotherapy more frequently as first-line chemotherapy, and less frequently targeted therapy. Their mortality was higher. It was shown that decision-making of colon cancer therapy is influenced by age according to our results.
由于合并症和老年综合征,尤其是衰弱,老年结肠癌患者的治疗决策变得更加复杂。在本研究中,我们旨在调查年轻和老年成年人在肿瘤特征、治疗选择和预后方面是否存在差异。
纳入2010年至2015年在我们中心被诊断为结直肠癌的患者。记录患者的肿瘤临床病理特征、治疗选择和生存率。根据实际年龄将患者分为两组。
本研究纳入465例患者,其中173例年龄在65岁及以上。两组的临床病理特征相似。辅助化疗的给予率相似。年轻患者作为一线治疗更倾向于联合化疗,而老年组则给予单药治疗(p值<0.001)。在老年成年人中,联合治疗和单药治疗在无进展生存期和总生存期方面未观察到显著差异(p值>0.05)。观察到53.2%的老年患者未接受任何生物治疗(p值<0.001)。
由于老年患者存在局限性,他们在临床试验中的代表性不足。我们的研究结果显示,老年结肠癌患者接受手术的比例低于年轻患者,他们更频繁地接受单药作为一线化疗,而接受靶向治疗的频率较低。他们的死亡率更高。根据我们的结果表明,结肠癌治疗的决策受年龄影响。