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Traitement des cancers digestifs du sujet âgé

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Les cancers digestifs du sujet âgé

Part of the book series: Oncologie pratique ((ONCOLPRAT))

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Résumé

Les cancers digestifs surviennent dans la grande majorité des cas chez les patients âgés de plus de 65 ans. Compte tenu du vieillissement de la population, l’incidence des cancers digestifs chez les sujets âgés va augmenter de façon importante au cours des prochaines années et la prise en charge de ces patients représente un véritable enjeu de santé publique.

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Références

  1. Remontet L, Esteve J, Bouvier AM et al. (2003) Cancer incidence and mortality in France over the period 1978–2000. Rev Epidemiol Sante Publique 51:3–30

    CAS  PubMed  Google Scholar 

  2. Repetto L, Comandini D, Mammoliti S (2001) Life expectancy, comorbidity and quality of life: the treatment equation in the older cancer patients. Crit Rev Oncol Hematol 37: 147–52

    Article  CAS  PubMed  Google Scholar 

  3. Zagonel V (2001) Importance of a comprehensive geriatric assessment in older cancer patients. Eur J Cancer 37 (Suppl 7): S229–S233

    Article  PubMed  Google Scholar 

  4. Mitry E, Bouvier AM, Esteve J et al. (2005) Improvement in colorectal cancer survival: A population-based study. Eur J Cancer 41: 2297–303

    Article  PubMed  Google Scholar 

  5. (2000) Surgery for colorectal cancer in elderly patients: a systematic review. Colorectal Cancer Collaborative Group. Lancet 356: 968–74

    Google Scholar 

  6. Arnaud JP, Schloegel M, Ollier JC et al. (1991) Colorectal cancer in patients over 80 years of age. Dis Colon Rectum 34: 896–8

    Article  CAS  PubMed  Google Scholar 

  7. Mitry E, Bouvier AM, Esteve J et al. (2002) Benefi t of operative mortality reduction on colorectal cancer survival. Br J Surg 89: 1557–62

    Article  CAS  PubMed  Google Scholar 

  8. Barrier A, Ferro L, Houry S et al. (2003) Rectal cancer surgery in patients more than 80 years of age. Am J Surg 185: 54–7

    Article  PubMed  Google Scholar 

  9. Brand MI, Saclarides TJ, Dobson HD et al. (2000) Liver resection for colorectal cancer: liver metastases in the aged. Am Surg 66: 412–5; discussion 415-6

    CAS  PubMed  Google Scholar 

  10. Bonavina L, Incarbone R, Saino G et al. (2003) Clinical outcome and survival after esophagectomy for carcinoma in elderly patients. Dis Esophagus 16: 90–3

    Article  CAS  PubMed  Google Scholar 

  11. Alexiou C, Beggs D, Salama FD et al. (1998) Surgery for esophageal cancer in elderly patients: the view from Nottingham. J Thorac Cardiovasc Surg 116: 545–53

    Article  CAS  PubMed  Google Scholar 

  12. Eguchi T, Fujii M, Takayama T (2003) Mortality for gastric cancer in elderly patients. J Surg Oncol 84: 132–6

    Article  PubMed  Google Scholar 

  13. Ishigami S, Natsugoe S, Hokita S et al. (1999) Strategy of gastric cancer in patients 85 years old and older. Hepatogastroenterology 46: 2091–5

    CAS  PubMed  Google Scholar 

  14. Kitamura K, Sugimachi K, Saku M (1999) Evaluation of surgical treatment for patients with gastric cancer who are over 80 years of age. Hepatogastroenterology 46: 2074–80

    CAS  PubMed  Google Scholar 

  15. Katai H, Sasako M, Sano T et al. (1998) The outcome of surgical treatment for gastric carcinoma in the elderly. Jpn J Clin Oncol 28: 112–5

    Article  CAS  PubMed  Google Scholar 

  16. Burcharth F, Olsen SD, Trillingsgaard J et al. (2001) Pancreaticoduodenectomy for periampullary cancer in patients more than 70 years of age. Hepatogastroenterology 48: 1149–52

    CAS  PubMed  Google Scholar 

  17. Fong Y, Blumgart LH, Fortner JG et al. (1995) Pancreatic or liver resection for malignancy is safe and effective for the elderly. Ann Surg 222: 426–34; discussion 434-7

    CAS  PubMed  Google Scholar 

  18. Hutchins LF, Unger JM, Crowley JJ et al. (1999) Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med 341: 2061–7

    Article  CAS  PubMed  Google Scholar 

  19. Lewis JH, Kilgore ML, Goldman DP et al. (2003) Participation of patients 65 years of age or older in cancer clinical trials. J Clin Oncol 21: 1383–9

    Article  PubMed  Google Scholar 

  20. Mahoney T, Kuo YH, Topilow A et al. (2000) Stage III colon cancers: why adjuvant chemotherapy is not offered to elderly patients. Arch Surg 135: 182–5

    Article  CAS  PubMed  Google Scholar 

  21. Extermann M, Albrand G, Chen H et al. (2003) Are older French patients as willing as older American patients to undertake chemotherapy? J Clin Oncol 21: 3214–9

    Article  PubMed  Google Scholar 

  22. Faivre-Finn C, Bouvier AM, Mitry E et al. (2002) Chemotherapy for colon cancer in a well-defi ned French population: is it under-or over-prescribed? Aliment Pharmacol Ther 16: 353–9

    Article  CAS  PubMed  Google Scholar 

  23. Navazesh A, Aparicio T, Sobhani I et al. (2003) La moitié des patients âgés de 75 et plus atteints d’un cancer colorectal ne bénéfi cie pas d’un traitement à visée carcinologique. Gastroenterol Clin Biol 27 (HS1): A103

    Google Scholar 

  24. Lemmens VE, van Halteren AH, Janssen-Heijnen ML et al. (2005) Adjuvant treatment for elderly patients with stage III colon cancer in the southern Netherlands is affected by socioeconomic status, gender, and comorbidity. Ann Oncol 16: 767–72

    Article  CAS  PubMed  Google Scholar 

  25. Iwashyna TJ, Lamont EB (2002) Effectiveness of Adjuvant Fluorouracil in Clinical Practice: A Population-Based Cohort Study of Elderly Patients With Stage III Colon Cancer. J Clin Oncol 20: 3992–8

    Article  CAS  PubMed  Google Scholar 

  26. Sundararajan V, Mitra N, Jacobson JS et al. (2002) Survival associated with 5-fluorouracil-based adjuvant chemotherapy among elderly patients with node-positive colon cancer. Ann Int Med 136: 349–57

    CAS  PubMed  Google Scholar 

  27. Sargent DJ, Goldberg RM, Jacobson SD et al.._(2001) A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients. N Engl J Med 345: 1091–7

    Article  CAS  PubMed  Google Scholar 

  28. Goldberg RM, Tabah-Fisch I, Bleiberg H et al. (2006) Pooled analysis of safety and effi cacy of oxaliplatin plus fluorouracil/leucovorin administered bimonthly in elderly patients with colorectal cancer. J Clin Oncol 24: 4085–91

    Article  CAS  PubMed  Google Scholar 

  29. Quasar Collaborative G, Gray R, Barnwell J et al. (2007) Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet 370: 2020–9

    Article  Google Scholar 

  30. Twelves C, Wong A, Nowacki MP et al. (2005) Capecitabine as adjuvant treatment for stage III colon cancer. N Engl J Med 352: 2696–704

    Article  CAS  PubMed  Google Scholar 

  31. Beretta G, Bollina R, Cozzi C et al. (1997) Should we consider the weekly (w) chemotherapy (CT) with fluorouracil (F) + racemic folinic acid (f) a standard treatment for advanced/metastatic carcinoma of digestive tract (DTC) in elderly patients (pts)? Proc Am Soc Clin Oncol 16: 259a

    Google Scholar 

  32. Simmonds PC (2000) Palliative chemotherapy for advanced colorectal cancer: systematic review and meta-analysis. Colorectal Cancer Collaborative Group. BMJ 321: 531–5

    Article  CAS  PubMed  Google Scholar 

  33. Chiara S, Nobile MT, Vincenti M et al. (1998) Advanced colorectal cancer in the elderly: results of consecutive trials with 5-fluorouracil-based chemotherapy. Cancer Chemother Pharmacol 42: 336–40

    Article  CAS  PubMed  Google Scholar 

  34. Magne N, Francois E, Broisin L et al. (2002) Palliative 5-Fluorouracil-based chemotherapy for advanced colorectal cancer in the elderly: results of a 10-year experience. Am J Clin Oncol 25: 126–30

    Article  PubMed  Google Scholar 

  35. Popescu RA, Norman A, Ross PJ et al. (1999) Adjuvant or palliative chemotherapy for colorectal cancer in patients 70 years or older. J Clin Oncol 17: 2412–8

    CAS  PubMed  Google Scholar 

  36. Stein BN, Petrelli NJ, Douglass HO et al. (1995) Age and sex are independent predictors of 5-fluorouracil toxicity. Analysis of a large scale phase III trial. Cancer 75: 11–7

    Article  CAS  PubMed  Google Scholar 

  37. Mabro M, Gilles-Amar V, Louvet C et al. (1999) 5-fluorouracile bimensuel en traitement du cancer colorectal métastasé chez le sujet âgé. Etude de 50 patients. Rev Med Interne 20: 863–8

    Article  CAS  PubMed  Google Scholar 

  38. Mattioli R, Lippe P, Recchia F et al. (2001) Advanced colorectal cancer in elderly patients: Tolerance and effi cacy of leucovorin and fluorouracil bolus plus continuous infusion. Anticancer Research 21: 489–92

    CAS  PubMed  Google Scholar 

  39. Daniele B, Rosati G, Tambaro R et al. (2003) First-line chemotherapy with fluorouracil and folinic acid for advanced colorectal cancer in elderly patients: a phase II study. J Clin Gastroenterol 36: 228–33

    Article  CAS  PubMed  Google Scholar 

  40. Folprecht G, Cunningham D, Ross P et al. (2004) Effi cacy of 5-fluorouracil-based chemotherapy in elderly patients with metastatic colorectal cancer: a pooled analysis of clinical trials. Ann Oncol 15: 1330–8

    Article  CAS  PubMed  Google Scholar 

  41. Feliu J, Escudero P, Llosa F et al. (2005) Capecitabine as fi rst-line treatment for patients older than 70 years with metastatic colorectal cancer: an oncopaz cooperative group study. J Clin Oncol 23: 3104–11

    Article  CAS  PubMed  Google Scholar 

  42. Cassidy J, Twelves C, Van Cutsem E et al. (2002) First-line oral capecitabine therapy in metastatic colorectal cancer: a favorable safety profi le compared with intravenous 5-fluorouracil/leucovorin. Ann Oncol 13: 566–75

    Article  CAS  PubMed  Google Scholar 

  43. Hochster HS, Luo W, Popa EC et al. (2007) Phase II study of uracil-tegafur with leucovorin in elderly (> or = 75 years old) patients with colorectal cancer: ECOG 1299. J Clin Oncol 25: 5397–402

    Article  CAS  PubMed  Google Scholar 

  44. Aparicio T, Desrame J, Lecomte T et al. (2003) Oxaliplatin-or irinotecan-based chemotherapy for metastatic colorectal cancer in the elderly. Br J Cancer 89: 1439–44

    Article  CAS  PubMed  Google Scholar 

  45. Berretta M, Bearz A, Frustaci S et al. (2006) FOLFOX2 regimen in the treatment of advanced colorectal cancer: a comparison between elderly and young patients. Ann Oncol 17: 1606–7

    Article  CAS  PubMed  Google Scholar 

  46. Figer A, Perez-Staub N, Carola E et al. (2007) FOLFOX in patients aged between 76 and 80 years with metastatic colorectal cancer: an exploratory cohort of the OPTIMOX1 study. Cancer 110: 2666–71

    Article  CAS  PubMed  Google Scholar 

  47. Feliu J, Salud A, Escudero P et al. (2006) XELOX (capecitabine plus oxaliplatin) as fi rstline treatment for elderly patients over 70 years of age with advanced colorectal cancer. Br J Cancer 94: 969–75

    Article  CAS  PubMed  Google Scholar 

  48. Comella P, Natale D, Farris A et al. (2005) Capecitabine plus oxaliplatin for the fi rst-line treatment of elderly patients with metastatic colorectal carcinoma. Cancer 104: 282–9

    Article  CAS  PubMed  Google Scholar 

  49. Rougier P, Mitry E, Cunningham D et al. (2003) Is age a prognostic factor of toxicity and effi cacy in patients (pts) with metastatic colorectal cancer (MCRC) receiving irinotecan in combination with 5FU/folinic acid (FA). Proc Am Soc Clin Oncol 22: 267

    Google Scholar 

  50. Folprecht G, Rougier P, Saltz L et al. (2006) Irinotecan in fi rst line therapy of elderly and non-elderly patients with metastatic colorectal cancer: Meta-analysis of four trials investigating 5-FU and irinotecan. J Clin Oncol 24 (ASCO Annual Meeting Proceedings Part I.): 3578

    Google Scholar 

  51. Mitry E, Phelip JM, Bonnetain F et al. (2008) Phase III trial of chemotherapy with or without irinotecan in the front-line treatment of metastatic colorectal cancer in elderly patients. FFCD 2001-02 trial. Results of a planned interim analysis, Gastrointestinal Cancers Symposium. Orlando, pp 209 (abstract 281)

    Google Scholar 

  52. Sastre J, Marcuello E, Masutti B et al. (2005) Irinotecan in combination with fluorouracil in a 48-hour continuous infusion as fi rst-line chemotherapy for elderly patients with metastatic colorectal cancer: a Spanish Cooperative Group for the Treatment of Digestive Tumors study. J Clin Oncol 23: 3545–51

    Article  CAS  PubMed  Google Scholar 

  53. Wilke H, Preusser P, Fink U et al. (1990) High dose folinic acid/etoposide/5-fluorouracil in advanced gastric cancer-a phase II study in elderly patients or patients with cardiac risk. Invest New Drugs 8: 65–70

    Article  CAS  PubMed  Google Scholar 

  54. Cubillo A, Cornide M, Lopez JL et al. (2001) Renal tolerance to cisplatin in patients 70 years and older. Am J Clin Oncol 24: 192–7

    Article  CAS  PubMed  Google Scholar 

  55. Schrag D, Gelfand SE, Bach PB et al. (2001) Who gets adjuvant treatment for stage II and III rectal cancer? Insight from surveillance, epidemiology, and end results—Medicare. J Clin Oncol 19: 3712–8

    CAS  PubMed  Google Scholar 

  56. Zachariah B, Balducci L, Venkattaramanabalaji GV et al. (1997) Radiotherapy for cancer patients aged 80 and older: a study of effectiveness and side effects. Int J Radiat Oncol Biol Phys 39: 1125–9

    CAS  PubMed  Google Scholar 

  57. Allal AS, Obradovic M, Laurencet F et al. (1999) Treatment of anal carcinoma in the elderly: feasibility and outcome of radical radiotherapy with or without concomitant chemotherapy. Cancer 85: 26–31

    Article  CAS  PubMed  Google Scholar 

  58. Allal AS, Mermillod B, Roth AD et al. (1997) Impact of clinical and therapeutic factors on major late complications after radiotherapy with or without concomitant chemotherapy for anal carcinoma. Int J Radiat Oncol Biol Phys 39: 1099–105

    CAS  PubMed  Google Scholar 

  59. Tanisada K, Teshima T, Ikeda H et al. (2000) A preliminary outcome analysis of the Patterns of Care Study in Japan for esophageal cancer patients with special reference to age: non surgery group. Int J Radiat Oncol Biol Phys 46: 1223–33

    CAS  PubMed  Google Scholar 

  60. Hurria A (2007) Incorporation of geriatric principles in oncology clinical trials. J Clin Oncol 25: 5350–1

    Article  PubMed  Google Scholar 

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Mitry, E., Aparicio, T., Rougier, P. (2010). Traitement des cancers digestifs du sujet âgé. In: Les cancers digestifs du sujet âgé. Oncologie pratique. Springer, Paris. https://doi.org/10.1007/978-2-8178-0000-4_5

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  • DOI: https://doi.org/10.1007/978-2-8178-0000-4_5

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-79513-8

  • Online ISBN: 978-2-8178-0000-4

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