Colorectal cancer treatment in elderly patients: results of a retrospective analysis addressed to the chiefs of medical oncology units in Italy.
BACKGROUND
The aim of this retrospective analysis was to evaluate the differences of 1-year treatment and chemotherapy related-toxicity in elderly colorectal cancer (CRC) patients in different Italian medical oncology units.


METHODS
An open questionnaire on the management of CRC patients over 70 years of age, from January to December 2004, was sent to Italian centres. One hundred and seventy-five files from 10 centres were analysed. Variables considered were age, gender, educational level, comorbidities and modality of therapy administration.


RESULTS
In only a minority of units were there some staff specifically dedicated to the older patients in close cooperation with geriatricians and the Multidimensional Geriatric Assessment (MGA) was not routinely used (11.2%-16.8% of cases). Only 5.7% patients were routinely enrolled in a protocol. In total, 95 out of 175 (54.3%) of CRC underwent adjuvant chemotherapy and 80 out of 175 (45.7%) received palliative chemotherapy. Of the patients who underwent adjuvant chemotherapy, 75.6% immediately accepted postoperative treatment while 12.2% were initially dubious but subsequently agreed. Only 5.5 and 9.7% of these patients reported very bad or bad tolerability, respectively. At disease progression, 62.5% patients accepted chemotherapy instantly while 33.3% accepted subsequently. Only 1.3% cases reported very bad and 1.3% bad tolerability.


CONCLUSIONS
In those units in which the problem of the elderly is actually recognised, CRC treatment is adequate, not influenced by age discrimination but inhomogeneous. In the future, standardizing treatment in different oncology units could prove to be beneficial to this population.
Pasetto
Lara Maria
LM
Istituto Oncologico Veneto, IRCCS, Oncologia Medica 2, Padova, Italy. laramary@libero.it
Falci
Cristina
C
Basso
Umberto
U
Gasparini
Giampietro
G
D'Andrea
Mario
M
Bonginelli
Paola
P
Bajetta
Emilio
E
Platania
Marco
M
Alabisio
Oscar
O
Miraglia
Stefania
S
Bertona
Erica
E
Oniga
Francesco
F
Biason
Rita
R
Chetrì
Maria Concetta
MC
Fedele
Palma
P
Massara
Giovanna
G
Romaniello
Incoronata
I
Negru
Maria Emanuela
ME
Giordano
Monica
M
Luchena
Giovanna
G
Buzzi
Franco
F
Ricotta
Riccardo
R
Siena
Salvatore
S
Monfardini
Silvio
S
D000368:Aged; D000369:Aged, 80 and over; D001290:Attitude; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000628:therapy*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008495:Medical Oncology / Q000458:organization & administration*; D010166:Palliative Care; D010349:Patient Compliance; D012189:Retrospective Studies; D011795:Surveys and Questionnaires