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 |
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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: |
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We analysed treatment decisions and course of therapy for patients with lung cancer in different age categories: <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 (<65 and 65–75). When patients did receive chemotherapy, primary and secondary treatment adaptations were effectuated in 58%: for patients aged <65 in 49%, for patients aged 65–75 and >75 years in 66%. For 44% of all patients treated with chemotherapy, unplanned hospital admissions were required: in 42% for the patients <65, in 52% for those aged 65–75 and in 27% for >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 & Sons Ltd</rights><rights>2017 John Wiley & Sons Ltd.</rights><rights>Copyright © 2018 John Wiley & 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: <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 (<65 and 65–75). When patients did receive chemotherapy, primary and secondary treatment adaptations were effectuated in 58%: for patients aged <65 in 49%, for patients aged 65–75 and >75 years in 66%. For 44% of all patients treated with chemotherapy, unplanned hospital admissions were required: in 42% for the patients <65, in 52% for those aged 65–75 and in 27% for >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><subject>Adaptation</subject><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Carcinoma, Non-Small-Cell Lung - drug therapy</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Case Managers</subject><subject>Chemotherapy</subject><subject>Clinical Decision-Making</subject><subject>Decision analysis</subject><subject>Decision making</subject><subject>ECOG PS</subject><subject>Female</subject><subject>geriatric</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - pathology</subject><subject>Male</subject><subject>MDT</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Nursing</subject><subject>Nutritional Status</subject><subject>Older people</subject><subject>Oncologists</subject><subject>Pathologists</subject><subject>Patient Care Team</subject><subject>Patient Preference</subject><subject>Patients</subject><subject>pulmonary malignancies</subject><subject>Pulmonologists</subject><subject>Quantitative analysis</subject><subject>Secondary treatment</subject><subject>Small Cell Lung Carcinoma - drug therapy</subject><subject>Small Cell Lung Carcinoma - pathology</subject><subject>Teams</subject><subject>Thoracic Surgery</subject><subject>treatment decisions</subject><issn>0961-5423</issn><issn>1365-2354</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kcFK7DAUhoMoOldd-AJScONdVJM0TdOlDOO9guJG1-U0PTNG26QmLTI7H8GFT-iTmHHUhWA2CYePj5z_J-SA0RMWzylqfcJ4IdUGmbBM5inPcrFJJrSULM0Fz3bInxDuKWUZK8U22eGqFFTlbELc1dgOpjFBm741FvwyaVCbYJx9e37p4MHYReJxAb5ZvfQddm64Qw_9Mpk7n7TjagpWo096GAzaIbw9v57ZBBYYDTUEbBLtuh68Cc7uka05tAH3P-9dcns-u5n-Ty-v_11Mzy5TnSmlUlXwAvJCApS11BnNkEsJIu6IOWWcNSVKBaIGVYuyFgXUjZZz0JxRQXlTZrvkeO3tvXscMQxVF3fEtgWLbgxVzIEXEVUiokc_0Hs3eht_F6mS0YLKnEfq75rS3oXgcV713nQxr4rRatVCFVuoPlqI7OGncaw7bL7Jr9gjcLoGnkyLy99N1Ww6XSvfAeAIlLw</recordid><startdate>201801</startdate><enddate>201801</enddate><creator>Schulkes, K.J.G.</creator><creator>Hamaker, M.E.</creator><creator>Lammers, J.‐W.J.</creator><creator>van Rens, M.T.M.</creator><creator>Geerts, M.</creator><creator>van Elden, L.J.R.</creator><general>Hindawi Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8FD</scope><scope>ASE</scope><scope>FPQ</scope><scope>FR3</scope><scope>K6X</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9384-7849</orcidid><orcidid>https://orcid.org/0000-0002-2261-9301</orcidid></search><sort><creationdate>201801</creationdate><title>Multidisciplinary decision‐making regarding chemotherapy for lung cancer patients—An age‐based comparison</title><author>Schulkes, K.J.G. ; Hamaker, M.E. ; Lammers, J.‐W.J. ; van Rens, M.T.M. ; Geerts, M. ; van Elden, L.J.R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3888-8727a576aa9b6c303e266a4276e50121d9e68a4ba8b49b47abdc6fac210402d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adaptation</topic><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Carcinoma, Non-Small-Cell Lung - drug therapy</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Case Managers</topic><topic>Chemotherapy</topic><topic>Clinical Decision-Making</topic><topic>Decision analysis</topic><topic>Decision making</topic><topic>ECOG PS</topic><topic>Female</topic><topic>geriatric</topic><topic>Geriatrics</topic><topic>Humans</topic><topic>Lung cancer</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Lung Neoplasms - pathology</topic><topic>Male</topic><topic>MDT</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Nursing</topic><topic>Nutritional Status</topic><topic>Older people</topic><topic>Oncologists</topic><topic>Pathologists</topic><topic>Patient Care Team</topic><topic>Patient Preference</topic><topic>Patients</topic><topic>pulmonary malignancies</topic><topic>Pulmonologists</topic><topic>Quantitative analysis</topic><topic>Secondary treatment</topic><topic>Small Cell Lung Carcinoma - drug therapy</topic><topic>Small Cell Lung Carcinoma - pathology</topic><topic>Teams</topic><topic>Thoracic Surgery</topic><topic>treatment decisions</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><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><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Technology Research Database</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Engineering Research Database</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cancer care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schulkes, K.J.G.</au><au>Hamaker, M.E.</au><au>Lammers, J.‐W.J.</au><au>van Rens, M.T.M.</au><au>Geerts, M.</au><au>van Elden, L.J.R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multidisciplinary decision‐making regarding chemotherapy for lung cancer patients—An age‐based comparison</atitle><jtitle>European journal of cancer care</jtitle><addtitle>Eur J Cancer Care (Engl)</addtitle><date>2018-01</date><risdate>2018</risdate><volume>27</volume><issue>1</issue><spage>e12768</spage><epage>n/a</epage><pages>e12768-n/a</pages><issn>0961-5423</issn><eissn>1365-2354</eissn><abstract>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: <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 (<65 and 65–75). When patients did receive chemotherapy, primary and secondary treatment adaptations were effectuated in 58%: for patients aged <65 in 49%, for patients aged 65–75 and >75 years in 66%. For 44% of all patients treated with chemotherapy, unplanned hospital admissions were required: in 42% for the patients <65, in 52% for those aged 65–75 and in 27% for >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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