Encouraging results in older patients receiving chemotherapy: a retrospective analysis of treatment guideline adherence in daily practice.

Objective: A retrospective study was performed to determine whether patients over 60 years old who received chemotherapy were treated according to the existing treatment guidelines and to investigate the reasons for dose reductions or treatment delay.

Material And Methods: Three hundred and seven patients aged over 60 years old and diagnosed with colon, breast or lung cancer between 1998 and 2008 who were treated with chemotherapy in the Radboud University Medical Center were included. From the medical records we recorded the number of and the reasons for dose reductions and delays. We calculated the relative dose intensity (RDI) received.

Results: RDI did not decrease significantly with age. However patients over 65 years of age had a higher probability of receiving a suboptimal dose intensity, even when treated with curative intent. There was no correlation between toxicity and age, however the comorbidity score increased with age. The average received RDI was higher in patients diagnosed more recently.

Conclusion: Despite increased comorbidity, older patients receiving chemotherapy were generally treated according to protocol without high incidence of severe toxicity. We saw improvement of RDI over the time period investigated. The participation of geriatricians in multidisciplinary oncology teams could help to optimize therapy decisions for patients with comorbidity.