title: Chemotherapy Regimen in Nonagenarian Cancer Patients: A Bi-Institutional Experience.
abstract: BACKGROUND
  The elderly population in Western countries is growing and constitutes a public health issue. Concomitantly, age-related diseases such as cancer increase. There are few data on the efficacy, tolerability and toxicity of specific anticancer therapy in the very elderly patients; therefore, their management is not standardized.
  
  
  METHODS
  In this bi-institutional study, we reviewed medical records of patients who received or continued specific anticancer therapy beyond the age of 90 years. Geriatric assessment was not reported for our patients. Twelve patients were enrolled. Their general health condition was good, and half of them were living in elderly institutions. Ten patients had a solid tumor and 2 were treated for hematological malignancies. Most were diagnosed with a locally advanced or metastatic disease, and the goal of treatment was curative for only 1 patient. Six patients received chemotherapy as first-line treatment, 4 patients received targeted therapy and 2 received concomitant chemoradiation. Four patients received a second-line treatment.
  
  
  RESULTS
  Despite a significant reduction in treatment posology in half of the patients, 8 acute grade 3/4 toxicities were reported and 2 patients died of treatment-related septic shock. Median duration of first-line treatment was 3.2 months, and progression-free survival ranged from 18 to 311 days. Overall survival ranged from 18 days to 11 years.
  
  
  CONCLUSIONS
  Aging is a heterogeneous process, and management of elderly patients is a multidisciplinary approach. Geriatric assessment helps to identify older patients with a higher risk of morbidity/mortality and allows to assess the risks and benefits of specific anticancer therapy. The choice of treatment should be based primarily on the expected symptomatic benefit, and treatment should not compromise the quality of life.
authors.forename: Romain
authors.initials: R
authors.lastname: Rivoirard
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.forename: Sharif
authors.initials: S
authors.lastname: Kullab
authors.forename: Jane-Chloé
authors.initials: JC
authors.lastname: Trone
authors.forename: Julien
authors.initials: J
authors.lastname: Langrand-Escure
authors.forename: Guillaume
authors.initials: G
authors.lastname: Moriceau
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Guy
authors.forename: Pierre
authors.initials: P
authors.lastname: Annede
authors.forename: Benoîte
authors.initials: B
authors.lastname: Méry
authors.forename: Coralie
authors.initials: C
authors.lastname: Moncharmont
authors.forename: Alexander Tuan
authors.initials: AT
authors.lastname: Falk
authors.forename: Lionel
authors.initials: L
authors.lastname: Vedrine
authors.forename: Yacine
authors.initials: Y
authors.lastname: Merrouche
authors.forename: Pierre
authors.initials: P
authors.lastname: Fournel
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
mesh_terms: D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use*; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D010166:Palliative Care