Toxicity of initial chemotherapy in older patients with lung cancers Journal Article
| Authors: | Zauderer, M. G.; Sima, C. S.; Korc-Grodzicki, B.; Kris, M. G.; Krug, L. M. |
| Article Title: | Toxicity of initial chemotherapy in older patients with lung cancers |
| Abstract: | Objectives: Despite the growing number of elderly patients with lung cancers, we lack adequate information about how best to treat them. A phase III trial demonstrated a survival benefit of doublet chemotherapy in elderly patients with lung cancers compared to single agents at the cost of increased toxicity. We undertook this study to identify and describe chemotherapy-associated toxicity patterns among elderly patients treated for lung cancers. Materials and methods: We reviewed records of patients age 70 or older with metastatic lung cancers who received initial chemotherapy at the Memorial Sloan-Kettering Cancer Center during 2008 and 2009. Results: We identified 70 patients: 28 (40%) completed at least 4. cycles of chemotherapy without dose reduction but 31 (44%) required hospitalization for toxicity. Baseline albumin < 3.5 g/dL and anemia were associated with grade 3-5 chemotherapy-associated toxicity. Also, an increase in platelets from cycle 1 to cycle 2 was associated with chemotherapy-associated toxicity. No other statistically significant associations between chemotherapy-associated toxicity and putative biologic and functional risk factors, including age and performance status, were identified. Conclusion: Patients deemed eligible for chemotherapy by their physicians were just as likely to have severe chemotherapy-associated toxicity requiring hospitalization as to finish an initial course of therapy without any serious problems. An increase in platelet count from cycle 1 to cycle 2 was associated with increased toxicity. Additional research, such as exploration of inflammatory cytokines (PDGF, IL6, and IGF-1) to identify the mechanisms of chemotherapy tolerance and prospective evaluation and validation of existing metrics, is needed so that all patients can be appropriately risk stratified. © 2012 Elsevier Ltd. |
| Keywords: | elderly; geriatric assessment; lung cancers; chemotherapy toxicity |
| Journal Title: | Journal of Geriatric Oncology |
| Volume: | 4 |
| Issue: | 1 |
| ISSN: | 1879-4068 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2013-01-01 |
| Start Page: | 64 |
| End Page: | 70 |
| Language: | English |
| DOI: | 10.1016/j.jgo.2012.09.003 |
| PROVIDER: | scopus |
| PMCID: | PMC3601754 |
| PUBMED: | 23525607 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 February 2013" - "Source: Scopus" |
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212Sima -
128Korc-Grodzicki -
178Krug -
188Zauderer -
869Kris
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