6 research outputs found
Do elderly patients with non-small cell lung cancer get the best out of recent advances in first-line treatment? A comparative study in two tertiary cancer centers in Greece
Background: Elderly patients with advanced non-small cell lung cancer
(NSCLC) are thought to receive suboptimal treatment mainly due to
concerns for poor compliance and/or excessive toxicity.
Patients and Methods: Using the age of 70 years as the pre-defined
cut-off, we compared elderly patients with advanced NSCLC suitable for
first line chemotherapy with their younger counterparts in terms of: i)
diagnosis and disease characteristics ii) adherence to treatment
schedule, including dose intensity (DI), and relative dose intensity
(RDI), iii) toxicity, tolerance, and efficacy outcomes.
Results: Among 292 eligible patients, data were available for 245, of
whom 107 (43.7%) belonged to the elderly group. This group was more
likely to present with co-morbidities, non-smoking current status and
diagnosis based on cytology alone. As compared to the non-elderly,
elderly patients were more likely to receive single-agent therapy (8.0%
vs. 29.2% respectively, p < 0.001) and less likely to receive
platinum-based chemotherapy (80.3% vs. 57.9%, p < 0.001). Elderly
patients also received docetaxel (24.3% vs. 40.4%), and bevacizumab
(7.5% vs. 21.3%) significantly less often and received oral
vinorelbine (24.3% vs. 11.8%) more frequently. Non-elderly patients
were more likely to receive any of the cytotoxic drugs with RDI > 0.8
(49.6% vs. 33.0%, p = 0.012) and RDI > 0.9 (29.6% vs. 16%, p =
0.015). Substantial toxicity, as well as median overall survival did not
differ significantly between the two groups.
Conclusions: Only one third of the elderly patients received at least
80% of the scheduled treatment intensity. Nearly half received
diagnosis based on cytology alone, which may deprive them from new,
histology-driven, therapeutic approaches. (C) 2014 Elsevier Ltd. All
rights reserved
Adrenal Incidentalomas in Cancer Patients Are Not Always “Innocent”: A Case Report and Review of the Literature
Herein, we report an unusual case of a 78-year-old woman with synchronous presentation of sigmoid cancer and a nonfunctioning primary adrenal cortex carcinoma, who developed superior vena cava syndrome due to metastatic lymphadenopathy from the latter malignancy. Our case suggests that adrenal incidentalomas during initial staging evaluation after cancer diagnosis are not always “innocent” and should not be “a priori” considered incidental findings attributed to hyperplasia, adenoma or even a non life-threatening metastasis from the primary tumor. It also emphasizes the importance of a continuous assessment of patients with synchronous primary malignancies, in order to timely evaluate changes in clinical or biological behavior and administrate the appropriate treatment