title: Sorafenib in elderly patients with advanced hepatocellular carcinoma: a case series.
abstract: OBJECTIVE
  The management of hepatocellular carcinoma (HCC) in elderly patients is significantly more complicated than in younger patients because of medical comorbidities, advanced status at diagnosis, reduced liver function and altered drug pharmacokinetics. Our objective was a revision of the charts of unselected elderly patients with HCC being treated with a reduced starting dose of sorafenib.
  
  
  METHODS
  Activity, adverse events and quality of life were evaluated during the treatment. Sixty patients (47 males and 13 females) aged more than 70 years old (range 70-90, median 76 years) were retrospectively reviewed.
  
  
  RESULTS
  One complete and one partial response were achieved in the series (overall response rate 3.3%). Stable disease accounted for 76.6% (46 out of 60 patients). The disease control rate (complete plus partial response plus stable disease) was 80%. Median time to progression (TTP) was 7.0 months (95% CI, 5.2-8.7 months) and median survival was 10.0 months (95% CI, 5.0-14.9 months). Thrombosis correlated to TTP. Full doses of sora-fenib were reached in 11 out of 60 patients (18.3%). The evaluation of quality of life did not show any significant change during the study.
  
  
  CONCLUSIONS
  Sorafenib at a reduced dose can be safely used in elderly HCC patients with maintenance of activity and increased tolerability.
authors: Unit of Medical Oncology, San Giovanni di Dio Hospital, IT–80067 Frattamaggiore, Italy. lilianamontella@libero.it
authors: Liliana
authors: L
authors: Montella
authors: Raffaele
authors: R
authors: Addeo
authors: Gregorio
authors: G
authors: Cennamo
authors: Bruno
authors: B
authors: Vincenzi
authors: Rita
authors: R
authors: Palmieri
authors: Pasquale
authors: P
authors: Sperlongano
authors: Rossella
authors: R
authors: Sperlongano
authors: Patrizia
authors: P
authors: Iodice
authors: Paola
authors: P
authors: Russo
authors: Salvatore
authors: S
authors: Del Prete
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D011788:Quality of Life; D012189:Retrospective Studies; D000077157:Sorafenib; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib