Quality of life in elderly patients with cancer

被引：54
作者：
Massimo Di Maio
Francesco Perrone
机构：
[1] Clinical Trials Unit, National Cancer Institute
来源：
Health and Quality of Life Outcomes | / 1卷 / 1期
关键词：
Vinorelbine; Clinical Cancer Research; Elderly Cancer Patient; High Eastern Cooperative Oncology Group; Lung Cancer Vinorelbine Italian Study;
D O I：
10.1186/1477-7525-1-44
中图分类号：
学科分类号：
摘要：
The incidence of most types of cancers is age-dependent and the progressive ageing is rapidly increasing the number of elderly people who need treatment for cancer. Elderly patients present peculiar characteristics that make the choice of the correct treatment more difficult and these patients are often undertreated. Moreover, elderly patients are largely underrepresented in cancer treatment trials, and this makes the experimental evidence on this topic even weaker. Health-related Quality of Life (QOL) has been considered as one of the hard end-points for clinical cancer research, and treatment of elderly cancer patients represents a typical situation where its assessment can be particularly useful, because the expected toxicity of treatment could be relevant in the discussion of the treatment choice. However, QOL assessment in the elderly is complicated by several unresolved methodological problems (higher frequency of illiteracy, worse compliance with the questionnaires, concomitant diseases, use of instruments not validated in the aged population). Conduct of clinical trials dedicated to elderly patients is now encouraged but there are few published studies. Advanced non-small-cell lung cancer is one of the fields with the largest amount of research on QOL in elderly patients. The ELVIS study demonstrated the efficacy of single-agent chemotherapy, both in terms of QOL and of survival. The MILES study, in which combination chemotherapy was not superior than single agents, showed that baseline QOL is a strong prognostic indicator in these patients. QOL of patients with breast cancer has been another important field in clinical research over the last decades, and interest on this topic in elderly patients is growing, from loco-regional to palliative treatment. In conclusion, some steps have been done in clinical cancer research dedicated to elderly patients, and the role of QOL assessment in this setting is important. However, many methodological problems must be resolved, in order to obtain reliable and useful results. A QOL assessment could also be useful for elderly patients in clinical practice, where it could improve patient-clinician communication: a wider application of properly selected instruments should be recommended. © 2003 Di Maio and Perrone; licensee BioMed Central Ltd.
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页数：9
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共 33 条
  • [1] Edwards B.K., Howe H.L., Ries L.A.G., Thun M.J., Rosenberg H.M., Yancik R., Wingo P.A., Jemal A., Feigal E.G., Annual report to the nation on the status of cancer, 1973-1999, featuring implications of age and aging on the US cancer burden, Cancer, 94, pp. 2766-2792, (2002)
  • [2] Ries L.A.G., Eisner M.P., Kosary C.L., Hankey B.F., Miller B.A., Clegg L., Mariotto A., Fay M.P., Feuer E.J., Edwards B.K., SEER Cancer Statistics Review, (2003)
  • [3] Repetto L., Balducci L., A case for geriatric oncology, Lancet Oncol., 3, pp. 289-297, (2002)
  • [4] Repetto L., Venturino A., Fratino L., Serraino D., Troisi G., Gianni W., Pietropaolo M., Geriatric oncology: A clinical approach to the older patient with cancer, Eur. J. Cancer, 39, pp. 870-880, (2003)
  • [5] Fentiman I.S., Tirelli U., Monfardini S., Schneider M., Festen J., Cognetti F., Aapro M.S., Cancer in the elderly: Why so badly treated?, Lancet, 335, pp. 1020-1022, (1990)
  • [6] Extermann M., Comprehensive geriatric assessment basics for the cancer professional, J. Oncol. Manag., 12, pp. 13-17, (2003)
  • [7] Hutchins L.F., Unger J.M., Crowley J.J., Coltman Jr. C.A., Albain K.S., Underrepresentation of patients 65 years of age or older in cancer-treatment trials, N. Engl. J. Med., 341, pp. 2061-2067, (1999)
  • [8] Lewis J.H., Kilgore M.L., Goldman D.P., Trimble E.L., Kaplan R., Montello M.J., Housman M.G., Escarce J.J., Participation of patients 65 years of age or older in cancer clinical trials, J. Clin. Oncol., 21, pp. 1383-1389, (2003)
  • [9] Talarico L., Chen G., Pazdur R., Elderly patients in trials for cancer drug registration: A 7-year experience by the Food and Drug Administration (FDA), Proc. Am. Soc. Clin. Oncol., 22, (2003)
  • [10] Outcomes of cancer treatment for technology assessment and cancer treatment guidelines, J. Clin. Oncol., 14, pp. 671-679, (1996)
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