Abstract
Cancer is mainly a disease of the elderly but clinical studies have generally excluded
the elderly population for various reasons. Chemotherapy is one of the strongest weapons
against (metastatic) cancer, but its use in the elderly has been limited due to fear
of inducing toxicity. This review points out 10 recommendations that need to be taken
into account when prescribing chemotherapy to elderly patients: aim of chemotherapy,
specific pharmacological data for specific chemotherapeutics, treatment individualisation,
alternatives to cytotoxic chemotherapy, comprehensive geriatric assessment, supportive
therapy, hydration status, drug interactions, and compliance. Each of these topics
will be reviewed here trying to give concrete recommendations for clinical practice.
Keywords
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References
- Pharmacology of anticancer drugs in the elderly population.Clin Pharmacokinet. 2003; 42: 1213-1242
- General guidelines for the management of older patients with cancer.Oncology (Huntingt). 2000; 14: 221-227
- The chemotherapy of lymphomas: looking back moving forward – the Richard and Hinda Rosenthal Foundation award lecture.Cancer Res. 1987; 47: 5810-5824
- Dose–response effect of adjuvant chemotherapy in breast cancer.N Engl J Med. 1981; 304: 10-15
- The importance of dose intensity in chemotherapy of metastatic breast cancer.J Clin Oncol. 1984; 2: 1281-1288
- The geriatric cancer patient: equal benefit from equal treatment.Cancer Control. 2001; 8: 1-25
- Can older cancer patients tolerate chemotherapy?.Cancer. 2003; 97: 1107-1114
- Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG).Crit Rev Oncol Hematol. 2005; 55: 241-252
- Population-based multidimensional assessment of older people in UK general practice: a cluster-randomised factorial trial.Lancet. 2004; 364: 1667-1677
- 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline.J Clin Oncol. 2006; 24: 3187-3205
- EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphomas and solid tumours.Eur J Cancer. 2006; 42: 2433-2453
- EORTC guidelines for the use of erythropoietic proteins in anaemic patients with cancer: 2006 update.Eur J Cancer. 2007; 43: 258-270
- International Society of Geriatric Oncology (SIOG) recommendations for the adjustment of dosing in elderly cancer patients with renal insufficiency.Eur J Cancer. 2007; 43: 14-34
- Pharmacokinetic drug interactions of commonly used anticancer drugs.Clin Pharmacokinet. 1986; 11: 223-235
- Pharmacokinetic drug interactions with anticancer drugs.Clin Pharmacokinet. 1994; 26: 486-500
- Vulnerability in the elderly: frailty.Med Clin North Am. 2006; 90: 593
Article info
Publication history
Published online: August 08, 2007
Accepted:
June 27,
2007
Received in revised form:
June 25,
2007
Received:
March 9,
2007
Identification
Copyright
© 2007 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
