Gastrointestinal Non Colorectal Cancer. Do Elderly Patients Need a Specific Management?

ISSN: 1875-5992 (Online)
ISSN: 1871-5206 (Print)

Volume 17, 14 Issues, 2017

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Anti-Cancer Agents in Medicinal Chemistry

Formerly: Current Medicinal Chemistry - Anti-Cancer Agents

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Michelle Prudhomme
Institut de Chimie de Clermont-Ferrand
Université Clermont Auvergne

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Gastrointestinal Non Colorectal Cancer. Do Elderly Patients Need a Specific Management?

Anti-Cancer Agents in Medicinal Chemistry, 13(9): 1364-1370.

Author(s): Lucrezia Silvestro, Guglielmo Nasti, Alessandro Ottaiano, Massimo Montano, Rossana Casaretti, Antonio Avallone, Massimiliano Berretta, Carmela Romano, Antonio Cassata, Salvatore Tafuto and Rosario Vincenzo Iaffaioli.

Affiliation: Department of Abdominal Oncology, National Cancer Institute “G. Pascale”- Via M.Semmola, 80131 Naples, Italy


Background: Elderly patients (65 years and over) develop often, sometimes predominantly , esophageal, gastro esophageal junction, gastric and pancreatic cancer (gastrointestinal non colorectal cancer). Most clinical trials exclude elderly patients from accrual considering aging a potential risk factor. In fact an elderly patient can develop greater toxicity than a younger patient from oncologic treatments (chemotherapy, radiotherapy, target therapies) due to a worse function of vital organs.

Methods: We analyzed the current scientific literature, searching articles since 1990, about gastrointestinal non colorectal cancer in elderly patients, to establish if they need a specific management, different from younger patients.

Results: Data from analyzed studies, both gastro esophageal and pancreatic cancer, are contradictory. In some reports elderly patients don’t seem to bring greater toxicity than younger. Other trials consider that dose-adjustment to renal function is need in elderly patients, but these trials are very few. Other trials may include several biases such as accrual of “only fit” elderly patients.

Conclusions: It is very important in elderly patients with higher risk of toxicity, to distinguish the aim of cancer treatment: is it curative or palliative? Furthermore, in this type of patients the most important target is probably maintaining the quality of life especially in gastric and pancreatic cancer that often started as advanced disease. For these valuation chronological age alone is not sufficient. Another very important factor in elderly cancer patients is the geriatric assessment including not only age but also functional, social and mental status.


Elderly, gastric cancer, pancreatic cancer, chemotherapy, target therapy.

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Article Details

Volume: 13
Issue Number: 9
First Page: 1364
Last Page: 1370
Page Count: 7
DOI: 10.2174/18715206113136660356
Price: $58
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