Palliative treatment for elderly patients with colon cancer in ten Italian medical oncology units.
BACKGROUND
Palliative chemotherapy significantly reduces mortality in patients with stage IV colon cancer, but is less prescribed with rising age. In this paper, we highlight the pattern of palliative treatment and possible effects on survival among elderly patients.


METHODS
From January to December 2004, 78 files on the management of stage IV colorectal cancer (CRC) patients over 70 years, collected from 10 Italian Centres, were retrospectively examined. Determinants of receipt of palliative chemotherapy and their relation to toxicity and survival were considered.


RESULTS
The proportion of elderly patients receiving first-line palliative chemotherapy was 98.7% and it was evaluated according to age, gender, educational level and comorbidities; patients receiving second-line therapy comprised 47.4%, those receiving third-line therapy 14.1% and those treated with a fourth-line therapy totalled 2.6%. Forty-one percent of patients received best supportive care (BSC) alone.


CONCLUSIONS
In Italy, a proportion of elderly patients with metastatic chemonaive CRC are usually treated with a tolerability and overall survival similar to those for the younger population. Among progressive patients after second-line therapy, 45.8% usually undergo third line therapy; the remaining 54.2% undergo BSC.
Pasetto
Lara Maria
LM
Oncologia Medical 2, Istituto Oncologico Veneto, IRCCS, Padova, Italy. laramary@libero.it
Falci
Cristina
C
Rizzo
Elisa
E
De Salvo
Gian Luca
GL
Gasparini
Giampietro
G
D'Andrea
Mario
M
Bajetta
Emilio
E
Platania
Marco
M
Alabiso
Oscar
O
Miraglia
Stefania
S
Oniga
Francesco
F
Biason
Rita
R
Chetrì
Maria Concetta
MC
Fedele
Palma
P
Massara
Giovanna
G
Romaniello
Incoronata
I
Giordano
Monica
M
Luchena
Giovanna
G
Buzzi
Franco
F
Ricotta
Riccardo
R
Siena
Salvatore
S
Monfardini
Silvio
S
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D000069287:Capecitabine; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D000077146:Irinotecan; D007558:Italy; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008495:Medical Oncology / Q000379:methods; D016685:Mitomycin / Q000008:administration & dosage; D009367:Neoplasm Staging; D016522:Oncology Service, Hospital; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010166:Palliative Care / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D005641:Tegafur / Q000008:administration & dosage; D014498:Uracil / Q000008:administration & dosage
D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D005641:Tegafur; D016685:Mitomycin; D014498:Uracil; D000069287:Capecitabine; D000077146:Irinotecan; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin