A study of tolerance to treatment among the most frequent cancer in the elderly

Abstract

18609 Background: Besides, aging may influence pharmacological aspects due to functional reserve deterioration and comorbidities, affecting tolerance to treatment and increasing the likelihood of complications. Methods: 166 cancer pts (56 lung, 64 breast, and 46 colon), mean age 72 yrs, treated with Ch/Rt were studied. Lung cancer pts had PS 0:1 (2%); PS 1:17 (30%); and PS2:38 (68%). Breast cancer pts had PS 0:6 (9%); PS 1:25 (39%); PS 2:33 (52%). Colon cancer pts had PS 0:6 (13%); PS 1:17 (37%); PS 2:23 (50%). Comorbidities were hypertension, diabetes, arrhythmia, EPOC, coronary and gastrointestinal disease. All of the pts had adequate cardiac, hepatic, renal and bone marrow functions. Allergy, cardiovascular, gastrointestinal, hepatic, neurological, haematological and renal toxicities, and infection were evaluated following the WHO criteria. Toxicities were studied according to age and comorbidities, and correlated with the use of other medicines. QoL was studied through the improvement of symptoms and PS evolution. The Chi Square test was used for statistical analyses. Results: The prevalence of common toxicities in the lung cancer pts were anemia, 39 pts (70%), infection, 37 pts (66%), leukopenia 33 pts (59%), gastrointestinal 28 pts (50%). The most common toxicities in breast cancer, were leukopenia 43 pts (67%), gastrointestinal 37 pts (58%), infection 36 pts (56%), and anemia 32 pts (50%), while in colon cancer pts the toxicities found were gastrointestinal 38 pts (83%), anemia 33 pts (72%), leukopenia 32 pts (70%), and infection 25 pts (54%). There was no correlation between age and the most frequent toxicities. Grade 2 was the most common level of toxicity reached in all types of cancer studied. There was improvement in QoL when symptoms evolution and PS were evaluated independently of cancer type, 81% (134 pts) for symptoms (p < 0.0001), and 72% (120 pts) for PS (p < 0.0001) respectively. There was no association between age and toxicity grade, irrespective of toxicity type, age and comorbidities. Conclusions: Older pts in good general condition and with controlled morbidities may receive Ch/Rt if this treatment modality results in improvement of their QoL.-Low toxicities occurred in most of these pts, probably due to the fact that pts were adequately selected. No significant financial relationships to disclose.