title: Assessment of solid cancer treatment feasibility in older patients: a prospective cohort study.
abstract: OBJECTIVE
  To assess solid cancer treatment feasibility in older patients.
  
  
  METHODS
  Between 2007 and 2010, 385 consecutive elderly patients (mean age: 78.9 ± 5.4 years; 47.8% males) with solid malignancies referred to two geriatric oncology clinics were included prospectively. We recorded feasibility of first-line chemotherapy (planned number of cycles in patients without metastases and three to six cycles depending on tumor site in patients with metastases), surgery (patient alive 30 days after successfully performed planned surgical procedure), radiotherapy (planned dose delivered), and hormonal therapy (planned drug dose given), and we recorded overall 1-year survival.
  
  
  RESULTS
  Main tumor sites were colorectal (28.6%), breast (23.1%), and prostate (10.9%), and 47% of patients had metastases. Planned cancer treatment was feasible in 65.7% of patients with metastases; this proportion was 59.0% for chemotherapy, 82.6% for surgery, 100% for radiotherapy, and 85.2% for hormonal therapy. In the group without metastases, feasibility proportions were 86.8% overall, 72.4% for chemotherapy, 95.7% for surgery, 96.4% for radiotherapy, and 97.9% for hormonal therapy. Factors independently associated with chemotherapy feasibility were good functional status defined as Eastern Cooperative Oncology Group performance status <2 (p < .0001) or activities of daily living >5 (p = .01), normal mobility defined as no difficulty walking (p = .01) or no fall risk (p = .007), and higher creatinine clearance (p = .04).
  
  
  CONCLUSIONS
  Feasibility rates were considerably lower for chemotherapy than for surgery, radiotherapy, and hormonal therapy. Therefore, utilization of limited geriatric oncology resources may be optimized by preferential referral of elderly cancer patients initially considered for chemotherapy to geriatric oncology clinics.
authors.affiliation: Université Paris Est, Faculté de Médecine, LIC, EA4393 Créteil, France; Département de Médecine Interne et Gériatrie, Unité de Coordination d'Onco-Gériatrie (UCOG-Sud Val de Marne), Service d'Oncologie Médicale, Service de Santé Publique, Unité de Recherche Clinique, Service de Radiothérapie, and Service de Pharmacie, AP-HP, Hôpital Henri-Mondor, Créteil, France; Centre hospitalier universitaire, Département de Neuroscience, Division Médecine gériatrique Angers, France; AP-HP Hôpital Paul Brousse, Service de soins de suite polyvalents, Villejuif, France; AP-HP, Hôpital Saint-Louis, Service d'Oncologie Médicale, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Laurent
authors.forename: Elena
authors.initials: E
authors.lastname: Paillaud
authors.forename: Christophe
authors.initials: C
authors.lastname: Tournigand
authors.forename: Philippe
authors.initials: P
authors.lastname: Caillet
authors.forename: Aurélie
authors.initials: A
authors.lastname: Le Thuaut
authors.forename: Jean-Léon
authors.initials: JL
authors.lastname: Lagrange
authors.forename: Olivier
authors.initials: O
authors.lastname: Beauchet
authors.forename: Hélène
authors.initials: H
authors.lastname: Vincent
authors.forename: Muriel
authors.initials: M
authors.lastname: Carvahlo-Verlinde
authors.forename: Stéphane
authors.initials: S
authors.lastname: Culine
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bastuji-Garin
authors.forename: Florence
authors.initials: F
authors.lastname: Canouï-Poitrine
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003625:Data Collection; D005240:Feasibility Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Cancer; Chemotherapy; Elderly; Feasibility studies; Treatment