79 / 154
A B S T R A C T S
S49
Median survival for elderly colorectal cancer was 43.38
months and 12.51 months for elderly pancreatic cancer.
Conclusion:
Despite geriatric parameters, adapted
FOLFIRINOX regimen seemed to have higher manageable
toxicities than younger with a particular attention to
neutropenia and diarrhea. Median survival in this metastatic
pancreatic population was similar to younger, and seemed to
be better in metastatic colorectal cancer than published.
mFOLFIRINOX can be administered in elderly with GCSF
prophylaxis to improve survival.
References
:
[1] Conroy,T et al. Folfirinox versus gemcitabine for metastatic
pancreatic cancer. N Engl J Med 2011;364:1817-25.
[2] Ychou et al. METHEP 2. Abstract 3512. ASCO 2016.
[3] Papamichael D et al. Treatment of colorectal cancer in
older patients : International Society of Geriatric oncology
(SIOG): consensus recommendations 2013. Ann Oncol 2015.
[4] Higuera et al. Management of pancreatic cancer in the
elderly. World J Gastroenterol 2016 January 14; 22(2): 764-
775
Disclosure of interest:
None declared
Keywords:
Folfirinox regimen, pancreatic and colorectal
elderly patients, survival, tolerance
P024
GERIATRIC ASSESSMENT AND FUNCTIONAL DECLINE IN
OLDER PATIENTS WITH LUNG CANCER
L. Decoster
1,
*, C. Kenis
2
, D. Schallier
1
, J. Vansteenkiste
2
,
K. Nackaerts
2
, L. Vanacker
1
, N. Vandewalle
1
, J. Flamaing
2
,
J. Lobelle
3
, K. Milisen
4
, J. De Grève
1
, H. Wildiers
2
1
UZ Brussel, Jette,
2
UZ Leuven, Leuven,
3
Consultant in statistics,
Beernem,
4
KU Leuven, Leuven, Belgium
Introduction:
Physicians treating lung cancer are con-
fronted with an expanding heterogeneous group of older
patients. Treatment of these patients is complex and focusses
on improving quality of life and prolonging overall survival
(OS). For this reason, maintenance of functional status (FS) is
a key endpoint.
Objectives:
The aim of the present study is to evaluate
the role of geriatric screening and geriatric assessment (GA)
as well as the evolution of FS in older patients 2-3 months
after the diagnosis of lung cancer, and to identify predictors
associated with functional decline and OS.
Methods:
Patients
70 years with a new diagnosis of
lung cancer in which a geriatric screening and a GA were
performed, were included. At baseline, all patients underwent
a uniform GA including FS measured by Activities of Daily
Living (ADL) and Instrumental Activities of Daily Living
(IADL). FS of patients was reassessed by repeating ADL and
IADL 2-3 months after diagnosis to define functional decline.
OS was collected. Determination of predictors of functional
decline on ADL and IADL and of OS was performed by
univariate and multivariable logistic and Cox regression.
Results:
245 patients with lung cancer were included from
October 2009 till January 2015. Median age was 76 years and
the majority of patients were male (72%) and had stage IV
disease (58%). Treatment consisted of surgery in 20 patients
(8%), radiotherapy in 105 patients (43%) of which neoadjuvant
in 1 patient, 66 curative in patients and palliative in 38 patients
and chemotherapy or targeted therapy in 125 patients (51%)
of which platinum doublet in 94 patients, monotherapy in
24 patients and targeted therapy in 6 patients. Forty-one
patients (17%) received only best supportive care. At baseline,
the screening tools G8 and Flemish version of triage risk
tool (fTRST) were abnormal (i.e.
14 and
1 respectively) in
respectively 91% and 83% of the patients. GA deficiencies were
observed in all domains but most prominent for fatigue (82%),
comorbidities (78%) and nutrition (76%). At baseline, ADL
and IADL impairments were detected in 126/245 (51%) and
154/245 (63%) of patients respectively. At follow-up, ADL and
IADL data were available for 145 patients. Functional decline
for ADL was observed in 23% (95%CI 16,2; 29,9) and for IADL
in 45% (95%CI 36,9;53,1) of patients. In multivariable analysis,
radiotherapy was predictive for ADL decline 2-3 months after
diagnosis. No other predictive factors for ADL or IADL were
identified. At the time of analysis, 45 out of 245 patients (18%)
were alive. In multivariable Cox regression, stage, gender and
age were predictive for survival .
Conclusion:
Older patients with lung cancer are a high
risk population which frequently presents at diagnosis with
deficiencies in all geriatric domains. Screening tools are
abnormal in almost 90% of patients, indicating that in this
subpopulation it might be indicated to perform GA in all
patients. During treatment functional decline is observed
in almost half of the patients, more prominently for IADL.
Functional decline on ADL at 2-3 months may be predicted
by radiotherapy, possibly related to the acute toxicities of this
treatment. Further follow-up at later time points is warranted
in order to investigate the evolution of functional decline.
None of the screening tools (G8, fTRST and ECOG-PS) nor the
specific domains of the GA were predictive for functional
decline or survival. Further research should focus on the role
of GA and interventions on evolution of quality of life.
Disclosure of interest:
None declared
Keywords:
Functional decline, geriatric assessment, older
lung cancer
P025
UTILITY OF GERIATRIC ASSESSMENT IN ELDERLY PATIENTS
WITH LOCALLY ADVANCED LUNG CANCER TO BE TREATED
WITH CONCURRENT CHEMORADIATION
M. T. Antonio Rebollo
1,
*, J. Saldaña
2
, J. Linares
2
, M. D. Arnaiz
2
,
J. C. Rufinelli
2
, J. Gonzalez-Barboteo
2
, V. Navarro
3
, A. Navarro
4
,
F. Cardenal
2
, E. Nadal
2
1
Medical Oncology, Institut Català d’Oncologia. Hospital Duran i
Reynals,
2
Medical Oncology,
3
Clinical Research Unit,
4
Radiotherapy
Oncology, Institut Català d’Oncologia-Hospital Duran i Reynals,
Barcelona, Spain
Introduction:
Because of the progressive aging of the
population, the number of elderly patients with NSCLC is