Clinical factors associated with the therapeutic outcome of chemotherapy in very elderly cancer patients

Int J Clin Oncol. 2019 May;24(5):596-601. doi: 10.1007/s10147-018-01385-8. Epub 2019 Jan 3.

Abstract

Background: The purpose of this study was to detect background factors that might be associated with the therapeutic and curative outcome of chemotherapy in elderly cancer patients aged over 75 years.

Methods: A retrospective study was conducted for elderly cancer patients aged over 75 years who had received more than 2 courses of chemotherapy at our hospital. We analyzed the relationships between RECIST outcome and background factors, such as age, sex, clinical TNM stage, pre-treatment history, ECOG performance status, serum albumin, and Charlson comorbidity index using logistic regression analysis.

Results: A total of 103 cancer patients aged over 75 years were analyzed in this study, including 28 with hematological neoplasia, 36 with gastrointestinal tract cancers, 25 with breast cancers, and 14 with other malignancies originating in various tissues. Seventy-one patients (69.1%) had a positive clinical outcome including RECIST CR (complete response), PR (partial response) and SD (stable disease). Multivariate analysis showed that a high serum albumin level of more than 3.5 g/dl and a Charlson comorbidity index score of less than 2 points were positively correlated with a favorable therapeutic outcome.

Conclusions: The results of the current study suggested that serum albumin level and comorbidity index are the principal clinical factors affecting therapeutic outcomes in elderly cancer patients receiving chemotherapy. In the future, these factors may make chemotherapy adaptations, continuity, and effectiveness easier to predict than GA screening.

Keywords: Chemotherapy; Comorbidity index; Elderly cancer patients; RECIST; Serum albumin.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / epidemiology
  • Case-Control Studies
  • Comorbidity
  • Female
  • Gastrointestinal Neoplasms / drug therapy
  • Gastrointestinal Neoplasms / epidemiology
  • Humans
  • Male
  • Neoplasms / drug therapy*
  • Neoplasms / epidemiology
  • Retrospective Studies
  • Serum Albumin, Human / analysis*
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Serum Albumin, Human