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Guidelines for the Management of the Older Cancer Patient

  • Chapter
Biological Basis of Geriatric Oncology

Part of the book series: Cancer Treatment and Research ((CTAR,volume 124))

3. Conclusions

The review allows the following conclusions:

  1. 1.

    Some form of geriatric assessment appear beneficial for older cancer patients; this assessment may allow to estimate life-expectancy and tolerance of treatment, to reveal reversible conditions that may influence the treatment, and to provide a common language to classify older individuals in clinical practice and clinical trials. The geriatric assessment is also the background of any decision analysis related to the study and the management of older patients, capable to accommodate new insights in the biology of cancer and aging and to address problems related to the management of specific diseases.

  2. 2.

    Some age related changes may affect the pharmacology of antineoplastic agents in the majority of older individuals and justify some general guidelines for the administration of chemotherapy that include:

    • Adjustment of the doses of the first chemotherapy to the glomerular filtration rate in individuals aged 65 and older. If no toxicity is observed, the following doses should be increased to prevent under-treatment

    • Prophylactic use of filgrastim or pegfilgrastim in patients aged 65 and older receiving chemotherapy of moderate dose intensity, comparable to CHOP

    • Maintenance of the hemoglobin of patients receiving chemotherapy at 12 gm/dl or higher Aggressive management of mucositis with timely fluid resuscitation

    • Prevention of mucositis by substituting capecitabine for intravenous fluorinated pyrimidine

Specific guidelines for the management of individual diseases may be necessary as illustrated. The geriatric assessment may provide the framework of reference to estimate benefits and risks.

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Authors and Affiliations

  1. Senior Adult Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida

    Lodovico Balducci (Program Leader and Professor of Oncology and Medicine)

  2. University of South Florida College of Medicine, Tampa, Florida

    Lodovico Balducci (Program Leader and Professor of Oncology and Medicine)

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  1. Lodovico Balducci
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Editors and Affiliations

  1. University of South Florida College of Medicine, Tampa, Florida, USA

    Lodovico Balducci MD (Professor of Oncology and Medicine and Program Leader) & Martine Extermann MD, PhD (Associate Professor of Oncology and Medicine) (Professor of Oncology and Medicine and Program Leader) &  (Associate Professor of Oncology and Medicine)

  2. Senior Adult Oncology Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida, USA

    Lodovico Balducci MD (Professor of Oncology and Medicine and Program Leader) & Martine Extermann MD, PhD (Associate Professor of Oncology and Medicine) (Professor of Oncology and Medicine and Program Leader) &  (Associate Professor of Oncology and Medicine)

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Balducci, L. (2005). Guidelines for the Management of the Older Cancer Patient. In: Balducci, L., Extermann, M. (eds) Biological Basis of Geriatric Oncology. Cancer Treatment and Research, vol 124. Springer, Boston, MA. https://doi.org/10.1007/0-387-23962-6_12

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  • DOI: https://doi.org/10.1007/0-387-23962-6_12

  • Publisher Name: Springer, Boston, MA

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