Multidisciplinary decision‐making regarding chemotherapy for lung cancer patients—An age‐based comparison

Optimising decision‐making in elderly patients is becoming increasingly urgent. We analysed treatment decisions and course of therapy for patients with lung cancer in different age categories:

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Veröffentlicht in:European journal of cancer care 2018-01, Vol.27 (1), p.e12768-n/a
Hauptverfasser: Schulkes, K.J.G., Hamaker, M.E., Lammers, J.‐W.J., van Rens, M.T.M., Geerts, M., van Elden, L.J.R.
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container_start_page e12768
container_title European journal of cancer care
container_volume 27
creator Schulkes, K.J.G.
Hamaker, M.E.
Lammers, J.‐W.J.
van Rens, M.T.M.
Geerts, M.
van Elden, L.J.R.
description Optimising decision‐making in elderly patients is becoming increasingly urgent. We analysed treatment decisions and course of therapy for patients with lung cancer in different age categories:
doi_str_mv 10.1111/ecc.12768
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We analysed treatment decisions and course of therapy for patients with lung cancer in different age categories: &lt;65, 65–75, and 75 years and older. About 349 patients with lung cancer (median age 67.8 years), discussed at the multidisciplinary team meeting in the Diakonessenhuis Utrecht, the Netherlands, were reviewed. Multidisciplinary decision‐making and subsequent clinical course were extracted from medical files. We found that 39% of eligible patients older than 75 years of age started treatment with chemotherapy compared to 80% of the younger patients (&lt;65 and 65–75). When patients did receive chemotherapy, primary and secondary treatment adaptations were effectuated in 58%: for patients aged &lt;65 in 49%, for patients aged 65–75 and &gt;75 years in 66%. For 44% of all patients treated with chemotherapy, unplanned hospital admissions were required: in 42% for the patients &lt;65, in 52% for those aged 65–75 and in 27% for &gt;75 years. The decision‐making process and course of treatment for lung cancer vary per age category. In particular, patients between 65 and 75 years of age might be more frail than initially thought. Age and frailty are important characteristics that need more attention.</description><identifier>ISSN: 0961-5423</identifier><identifier>EISSN: 1365-2354</identifier><identifier>DOI: 10.1111/ecc.12768</identifier><identifier>PMID: 28940851</identifier><language>eng</language><publisher>England: Hindawi Limited</publisher><subject>Adaptation ; Adult ; Age ; Age Factors ; Aged ; Aged, 80 and over ; Cancer ; Cancer therapies ; Carcinoma, Non-Small-Cell Lung - drug therapy ; Carcinoma, Non-Small-Cell Lung - pathology ; Case Managers ; Chemotherapy ; Clinical Decision-Making ; Decision analysis ; Decision making ; ECOG PS ; Female ; geriatric ; Geriatrics ; Humans ; Lung cancer ; Lung Neoplasms - drug therapy ; Lung Neoplasms - pathology ; Male ; MDT ; Middle Aged ; Neoplasm Staging ; Nursing ; Nutritional Status ; Older people ; Oncologists ; Pathologists ; Patient Care Team ; Patient Preference ; Patients ; pulmonary malignancies ; Pulmonologists ; Quantitative analysis ; Secondary treatment ; Small Cell Lung Carcinoma - drug therapy ; Small Cell Lung Carcinoma - pathology ; Teams ; Thoracic Surgery ; treatment decisions</subject><ispartof>European journal of cancer care, 2018-01, Vol.27 (1), p.e12768-n/a</ispartof><rights>2017 John Wiley &amp; Sons Ltd</rights><rights>2017 John Wiley &amp; Sons Ltd.</rights><rights>Copyright © 2018 John Wiley &amp; Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3888-8727a576aa9b6c303e266a4276e50121d9e68a4ba8b49b47abdc6fac210402d93</citedby><cites>FETCH-LOGICAL-c3888-8727a576aa9b6c303e266a4276e50121d9e68a4ba8b49b47abdc6fac210402d93</cites><orcidid>0000-0001-9384-7849 ; 0000-0002-2261-9301</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fecc.12768$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fecc.12768$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28940851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schulkes, K.J.G.</creatorcontrib><creatorcontrib>Hamaker, M.E.</creatorcontrib><creatorcontrib>Lammers, J.‐W.J.</creatorcontrib><creatorcontrib>van Rens, M.T.M.</creatorcontrib><creatorcontrib>Geerts, M.</creatorcontrib><creatorcontrib>van Elden, L.J.R.</creatorcontrib><title>Multidisciplinary decision‐making regarding chemotherapy for lung cancer patients—An age‐based comparison</title><title>European journal of cancer care</title><addtitle>Eur J Cancer Care (Engl)</addtitle><description>Optimising decision‐making in elderly patients is becoming increasingly urgent. We analysed treatment decisions and course of therapy for patients with lung cancer in different age categories: &lt;65, 65–75, and 75 years and older. About 349 patients with lung cancer (median age 67.8 years), discussed at the multidisciplinary team meeting in the Diakonessenhuis Utrecht, the Netherlands, were reviewed. Multidisciplinary decision‐making and subsequent clinical course were extracted from medical files. We found that 39% of eligible patients older than 75 years of age started treatment with chemotherapy compared to 80% of the younger patients (&lt;65 and 65–75). When patients did receive chemotherapy, primary and secondary treatment adaptations were effectuated in 58%: for patients aged &lt;65 in 49%, for patients aged 65–75 and &gt;75 years in 66%. For 44% of all patients treated with chemotherapy, unplanned hospital admissions were required: in 42% for the patients &lt;65, in 52% for those aged 65–75 and in 27% for &gt;75 years. 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We analysed treatment decisions and course of therapy for patients with lung cancer in different age categories: &lt;65, 65–75, and 75 years and older. About 349 patients with lung cancer (median age 67.8 years), discussed at the multidisciplinary team meeting in the Diakonessenhuis Utrecht, the Netherlands, were reviewed. Multidisciplinary decision‐making and subsequent clinical course were extracted from medical files. We found that 39% of eligible patients older than 75 years of age started treatment with chemotherapy compared to 80% of the younger patients (&lt;65 and 65–75). When patients did receive chemotherapy, primary and secondary treatment adaptations were effectuated in 58%: for patients aged &lt;65 in 49%, for patients aged 65–75 and &gt;75 years in 66%. For 44% of all patients treated with chemotherapy, unplanned hospital admissions were required: in 42% for the patients &lt;65, in 52% for those aged 65–75 and in 27% for &gt;75 years. The decision‐making process and course of treatment for lung cancer vary per age category. In particular, patients between 65 and 75 years of age might be more frail than initially thought. Age and frailty are important characteristics that need more attention.</abstract><cop>England</cop><pub>Hindawi Limited</pub><pmid>28940851</pmid><doi>10.1111/ecc.12768</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0001-9384-7849</orcidid><orcidid>https://orcid.org/0000-0002-2261-9301</orcidid><oa>free_for_read</oa></addata></record>
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subjects Adaptation
Adult
Age
Age Factors
Aged
Aged, 80 and over
Cancer
Cancer therapies
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Non-Small-Cell Lung - pathology
Case Managers
Chemotherapy
Clinical Decision-Making
Decision analysis
Decision making
ECOG PS
Female
geriatric
Geriatrics
Humans
Lung cancer
Lung Neoplasms - drug therapy
Lung Neoplasms - pathology
Male
MDT
Middle Aged
Neoplasm Staging
Nursing
Nutritional Status
Older people
Oncologists
Pathologists
Patient Care Team
Patient Preference
Patients
pulmonary malignancies
Pulmonologists
Quantitative analysis
Secondary treatment
Small Cell Lung Carcinoma - drug therapy
Small Cell Lung Carcinoma - pathology
Teams
Thoracic Surgery
treatment decisions
title Multidisciplinary decision‐making regarding chemotherapy for lung cancer patients—An age‐based comparison
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