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The Oncologist, Vol. 11, No. 3, 234-242, March 2006; doi:10.1634/theoncologist.11-3-234
© 2006 AlphaMed Press

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Adjuvant Chemotherapy in the Elderly: Whom to Treat, What Regimen?

Susan Burdette-Radoux, Hyman B. Muss

Hematology/Oncology Unit, University of Vermont, Fletcher Allen Health Care, Burlington, Vermont, USA

Key Words. Aged • Chemotherapy • adjuvant • Neoplasms • Risk assessment

Correspondence: Susan Burdette-Radoux, M.D., Hematology/Oncology Unit, University of Vermont, Fletcher Allen Health Care, UHC Campus, St. Joseph 3400, One South Prospect Street, Burlington, Vermont 05401, USA. Telephone: 802-847-3827; Fax: 802-847-3510; e-mail: Susan.Burdette-Radoux{at}vtmednet.org

As the elderly population continues to grow, adjuvant chemotherapy treatment in the elderly is becoming an increasingly important issue for the practicing oncologist. Decisions regarding adjuvant treatment involve a careful assessment of the risk for recurrent disease and side effects from treatment, balancing these risks against the beneficial effects of treatment. In this review, we discuss methods for assessing the elderly patient in terms of life expectancy, comorbid disease, and functional capacity. This assessment can then be used to help identify appropriate candidates for adjuvant chemotherapy. Tools for estimating the risk for relapse and mortality and the reduction in these risks with various forms of treatment are useful for clarifying treatment options. Elderly patients have been underrepresented in clinical trials, and patients are often given less intense and possibly inferior standard treatment as a function of age. Ongoing clinical trials targeting the elderly patient may help answer questions about the relative risks and benefits of adjuvant treatment in this age group. Recent data show that most fit elderly patients derive a benefit from standard adjuvant chemotherapy regimens that is equal to that of younger patients.




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[Abstract] [Full Text] [PDF]


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