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[2] Goldberg et al. Pooled Analysis of Safety and Efficacy of
Oxaliplatin Plus Fluorouracil/Leucovorin Administered
Bimonthly in Elderly PatientsWith Colorectal Cancer. J Clin
Oncol 2006; 24:4085-4091.
[3] Aparicio et al. Geriatric Factors Predict Chemotherapy
Feasibility: Ancillary Results of FFCD 2001-02 Phase III
Study in First-Line Chemotherapy for Metastatic Colorectal
Cancer in Elderly Patients. J Clin Oncol 2013; 31:1464-1470.
Disclosure of interest:
None declared
Keywords:
5FU, chemotherapy toxicities, colorectal and
pancreatic cancer, elderly, therapeutic dose monitoring
P076
OLDER PATIENTS RECEIVING CHEMOTHERAPY:
CHARACTERISING THE POPULATION
F. Holt
1
, M. Denholm
1,
*, J. Hampton
2
, P. Corrie
3
1
Department of Oncology and Department of Medicine for the
Elderly,
2
Department of Medicine for the Elderly,
3
Department of
Oncology, Cambridge University Hospitals NHS Foundation Trust,
Cambridge, United Kingdom
Introduction:
Due to an ageing population, increasing
numbers of older patients are being referred for cancer
chemotherapy. The proportion of patients over the age of 75
entering clinical trials is tiny so little is known about the true
risks and benefits of treating older people.
Objectives:
We undertook a review of our local
chemotherapy dataset, in order to benchmark our current
practice and consider future requirements of an oncogeriatric
service.
Methods:
The electronic medical records of patients
over 75 years old receiving chemotherapy at Cambridge
University Hospital NHS Foundation Trust between October
2014 and October 2015 were reviewed. The following patient
characteristics were determined: age, sex, ECOG performance
status (PS), cancer diagnosis, treatment intent, number of
medications, updated Charlson Co-morbidity Index (CCI),
independence with personal activities of daily living (PADL).
Results:
311 patients receiving chemotherapy had an
average age of 80 years, range: 75-95 years, 53% were male.
161 (52%) patients had a solid tumour diagnosis, 150 (47%) had
a haematological malignancy. 274 (88%), were treated with
non-curative/palliative intent, 37 (12%) with curative intent.
PS was recorded in 139 (45%) cases and the split was 0 (21%),
1 (62%), 2 (14%), 3 (3%). 208 (67%) patients were independent
with PADL. The average number of medications taken was 5.
The average CCI was 1.8.
Conclusion:
The majority of older patients receiving
chemotherapy were being treated with palliative intent.
ECOG PS was not available for over half of patients, which
may reflect poor documentation, or difficulty categorising
older people using this scale. One third of patients were not
independent with PADL, while polypharmacy and the CCI
of 1.8 are all triggers for justifying comprehensive geriatric
assessment in at least some of these patients. This review
supports the need for better tools to assess older patients
receiving chemotherapy and closer integration of oncology
and geriatric services in the future.
Disclosure of interest:
None declared
Keywords:
Chemotherapy
P077
SALVAGE SURGERY OF NON-SMALL CELL LUNG CANCER IN
ELDERLY PATIENTS WITH PREVIOUS WEDGE RESECTION OR
LOBECTOMY
A. Tortoriello
1
, A. J. Blair
1
, C. E. B. Iniguez
1
, M. T. Jaklitsch
1,
*
1
Brigham & Women’s Hospital, Boston, USA
Introduction:
In younger patients, lobectomy offers greater
survival than limited resection for early stage lung cancer
[1]. This benefit is not evident after age 71, but without clear
rationale [2].
Objectives:
To assess the following differences between
elderly patients treated with lobectomy versus limited
resection: 1) disease free and overall survival, 2) recurrence
rates, and 3) risk factors contributing to a difference in survival.
Methods:
A total of 4,015 patients underwent lung
cancer surgery by a single surgeon between 1998 and 2010.
164 patients were
65 years of age, underwent lobectomy
or limited resection with histology revealing early stage
NSCLC. Patients were grouped in two categories: patients that
underwent a limited resection (n=74; 45%) and patients that
underwent a lobectomy (n=90; 55%). 18 patients underwent
resection and had a recurrence, five of whom initially
underwent a lobectomy, the other 13 underwent a limited
resection. Perioperative risk factors included in the analysis
were: age at surgery, cancer stage, FEV1, histology, tumor
size, and whether the cancer had invaded the pleura. Log-
rank tests and Cox regression models were used for survival
analysis.
Results:
A total of 84 (51%) men and 80 (49%) women (mean
age 75) with stage I (76%) or stage II NSCLC were analyzed.
There was a significant difference in disease free survival
between the two groups (p=0.0008). Of the five patients
who underwent an initial lobectomy, the mean time until
recurrence was 1849 days ± 1135 (5.0 years), whereas time
to recurrence for limited resection was 583 days ± 301 (1.6
years). Despite a difference in recurrence rate, there was no
significant difference in 5-year survival between the groups
(p=0.23), likely due to salvage surgery. Specifically, two of five
(40%) of patients with lung recurrence after lobectomy had
salvage surgery without recurrence, and seven of 13 (54%) of
recurrences after limited resection were salvaged. Age and
FEV1 were predictors of survival for those who underwent
limited resection and stage II disease was a predictor for
lobectomy. There were four deaths within 30 days (2.4% 30-
day mortality) and two deaths within 90 days (3.7% 90-day
mortality). Five of the six deaths within the first 90 days were
recovering from lobectomy (5.6% 90-day mortality following
lobectomy). The death after wedge resection occurred on the
80
th
day (no 30-day mortality and 1.5% 90-day mortality for
wedge).