Seniors Getting Chemo May Have More Adverse Events
Increased events necessitate a trade-off between symptom management and treatment toxicity
FRIDAY, Jan. 1 (HealthDay News) -- Older patients with non-small-cell lung cancer (NSCLC) who get chemotherapy have higher risk of adverse events, necessitating a balance between symptom management and treatment risks, according to a study published online Dec. 28 in the Journal of Clinical Oncology.
Elizabeth A. Chrischilles, Ph.D., of the University of Iowa in Iowa City, and colleagues studied 1,371 patients with stages IIIB and IV NSCLC. The researchers conducted interviews, reviewed patient records, and assessed the incidence of adverse events experienced in chemotherapy, such as pneumonia, thrombosis, cardiac event and stroke. They analyzed associations between chemotherapy and age, adjusting for sex, ethnicity, cancer stage, radiation therapy, histology and comorbidities.
Overall, the researchers found that 58 percent of the patients got chemotherapy, with 35 percent of those experiencing an adverse event. Chemotherapy was used more in younger patients and less in the elderly, and platinum-based therapies were less commonly used with the older patients. While patients 75 years and older had lower rates for pretreatment medical events (9.2 percent) than those under 55 (18.6 percent), adverse events were more common in older adults (rate ratios, 1.70 for 65- to 74-year-olds and 1.34 for those at least 75 years old).
"Older patients who received chemotherapy had fewer pretherapy events than younger patients and were less likely to receive platinum-based regimens. Nevertheless, older patients had more adverse events during chemotherapy, independent of comorbidity. Potential implicit trade-offs between symptom management and treatment toxicity should be made explicit and additionally studied," the authors write.
The author of the accompanying editorial reported financial relationships with the pharmaceutical industry.