A dilemma in geriatric oncology: malignant bowel obstruction in an 81-year-old man.
An 81-year-old male presenting with bowel obstruction was found upon examination to have bilobar liver metastases. In light of the patient's advanced age, bowel resection was foregone in favor of stent deployment, which led to rapid resolution of symptoms. The multidisciplinary team assembled to coordinate further care advised the use of chemotherapy with irinotecan, oxaliplatin, and 5-FU, which was well tolerated and led to an objective response. The special considerations relevant to the patient's advanced age, including the choice of stent deployment rather than resection and the decision to employ 5-FU-based chemotherapy in spite of limited trial data with this approach in patients of advanced age, are explained in detail.
Mitry
Emmanuel
E
Hôpital Ambroise Paré, APHP, Boulogne, France. emmanuel.mitry@apr.aphp.fr
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D007415:Intestinal Obstruction / Q000473:pathology*; D000077146:Irinotecan; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin
D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000077146:Irinotecan; D005472:Fluorouracil; D002166:Camptothecin