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Cancer in the elderly: Research fails to keep up with demographic change
Date:5/11/2012

the best way of selecting patients for specific treatment, says Professor Sebag-Montefiore.

"Although a patient's treatment should not be determined purely on the basis of age, we need to take into account the fact that things like the length of treatment, which often takes place over five to six weeks, and the travel time to cancer centres can weigh much more heavily on an older person. And although most trials do not have an upper age limit, many studies exclude patients with co-morbidities and usually the median age in such trials is significantly lower than that of the general population. So we need to design studies urgently to address these problems if we are to be able to provide the best evidence-based treatment to an ageing population," he says.

Chemotherapy also poses problems for older people, says Dr. Laura Biganzoli, from the Hospital of Prato, Istituto Toscano Tumori, Prato, Italy. "Recommendations for treatment are largely based on limited retrospective subgroup analyses from larger trials and the extrapolation of study results from younger patients. This is clearly inappropriate, since breast cancer biology differs in older patients, treatment tolerance varies, and there are the ever-present problems of co-morbidities."

Only two published studies have prospectively evaluated the role of chemotherapy in elderly breast cancer patients, and a retrospective study has found a higher risk of treatment-related deaths in older women. "In addition to the lack of clinical trials dedicated to older patients," says Dr. Biganzoli, "we also need to design studies for those who are vulnerable and frail."

In radiotherapy under-treatment after breast conserving surgery is common, she says. "The CALGB [3] trial 9343 showed that not giving radiotherapy to women with early stage breast cancer with oestrogen receptor positive tumours who had breast conserving surgery and were taking tamoxifen had no impact on survival but was assoc
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Contact: Mary Rice
mary.rice@riceconseil.eu
European Society for Radiotherapy and Oncology (ESTRO)
Source:Eurekalert

Page: 1 2 3 4

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