Abstract
BackgroundPopulation of oldest old will grow dramatically in the next future and cancer, physiologically related to aging, will be very prevalent among them. Lack of evidence is a huge problem to manage cancer in oldest old and will be more and more in the next years.AimsOur purpose was to investigate the characteristics of a population of oldest old patients with cancer treated in the Radiation Oncology Unit of Fondazione Policlinico A. Gemelli IRCCS.MethodsWe conducted a retrospective study. The primary outcome was to evaluate which characteristics of the population could influence the choice of oncological treatment (with radical or non-radical intent).ResultsWe identified a total of 348 patients: 140 were on follow-up; 177 were under treatment; 31 were considered not eligible for treatments. Patients under treatment had a high comorbidity index (mean Charlson Comorbidity Index 5.4), and a high prevalence of polypharmacy (mean number of drugs 5.6). More than half (53.1%) was treated with radical intent. Patients treated with radical intent were 1 year younger (87.1 years old vs 88.1 years old), more performant (ECOG 0.7 vs 1.3), and had less prevalence of metastatic neoplasia (6.4% vs 34.9%); comorbidities and drugs did not show differences in the two groups.ConclusionOldest old, usually not considered in international guidelines, are treated for oncological disease, often with radical intent. The treatment seems not to be tailored considering comorbidities but on performance status.
Highlights
The scientific community is preparing to the so-called “Silver Tsunami”: in the future, the population of elderly people will grow, and it will deeply change the world and the healthcare scenario
The aim of our study was to investigate the characteristics of a population of oldest old treated by the Radiation Oncology Unit in a University Hospital, and how these features affect the intent of the prescribed oncological treatment
We conducted a retrospective study to investigate the characteristics of a population of oldest old patients treated in the Radiation Oncology Unit (Gemelli ART—Advanced Radiation Oncology) of Fondazione Policlinico A
Summary
The scientific community is preparing to the so-called “Silver Tsunami”: in the future, the population of elderly people will grow, and it will deeply change the world and the healthcare scenario. An important epidemiologic study made in United States on oncological patients aged 85 or older was published; the study showed that, to date, 8% of all new cancer diagnosis are made in the oldest old [10]. Population of oldest old will grow dramatically in the future and cancer, physiologically related to aging, will be very prevalent among them. Aims Our purpose was to investigate the characteristics of a population of oldest old patients with cancer treated in the Radiation Oncology Unit of Fondazione Policlinico A. Patients treated with radical intent were 1 year younger (87.1 years old vs 88.1 years old), more performant (ECOG 0.7 vs 1.3), and had less prevalence of metastatic neoplasia (6.4% vs 34.9%); comorbidities and drugs did not show differences in the two groups. Conclusion Oldest old, usually not considered in international guidelines, are treated for oncological disease, often with radical intent. The treatment seems not to be tailored considering comorbidities but on performance status
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