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dc.contributor.authorChrischilles, Elizabeth A.
dc.contributor.authorPendergast, Jane F.
dc.contributor.authorKahn, Katherine L.
dc.contributor.authorWallace, Robert B.
dc.contributor.authorMoga, Daniela C.
dc.contributor.authorHarrington, David P.
dc.contributor.authorKiefe, Catarina I.
dc.contributor.authorWeeks, Jane C.
dc.contributor.authorWest, Dee W.
dc.contributor.authorZafar, S. Yousuf
dc.contributor.authorFletcher, Robert H.
dc.date2022-08-11T08:10:36.000
dc.date.accessioned2022-08-23T17:14:16Z
dc.date.available2022-08-23T17:14:16Z
dc.date.issued2009-12-30
dc.date.submitted2010-04-27
dc.identifier.citationJ Clin Oncol. 2010 Feb 1;28(4):620-7. Epub 2009 Dec 28. <a href="http://dx.doi.org/10.1200/JCO.2009.23.8485">Link to article on publisher's site</a>
dc.identifier.issn0732-183X (Linking)
dc.identifier.doi10.1200/JCO.2009.23.8485
dc.identifier.pmid20038726
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46919
dc.description.abstractPURPOSE: To describe chemotherapy use and adverse events (AEs) for advanced-stage, non-small-cell lung cancer (NSCLC) in community practice, including descriptions according to variation by age. METHODS: We interviewed patients with newly diagnosed, stages IIIB and IV NSCLC in the population-based cohort studied by the Cancer Care Outcomes Research and Surveillance Consortium, and we abstracted the patient medical records. AEs were medical events occurring during chemotherapy. Using logistic regression, we assessed the association between age and chemotherapy; with Poisson regression, we estimated event rate ratios and adjusted the analysis for age, sex, ethnicity, radiation therapy, stage, histology, and presence and grade of 27 comorbidities. RESULTS: Of 1,371 patients, 58% (95% CI, 55% to 61%) received chemotherapy and 35% (95% CI, 32% to 38%) had AEs. After adjustment, 72% (95% CI, 65% to 79%) of those younger than 55 years and 47% (95% CI, 42% to 52%) of those age 75 years and older received chemotherapy. Platinum-based therapies were less common in the older-age groups. Pretreatment medical event rates were 18.6% for patients younger than 55 years and were only 9.2% for those age 75 years and older (adjusted rate ratio, 0.49; 95% CI, 0.26 to 0.91). In contrast, older adults were more likely to have AEs during chemotherapy. The adjusted rate ratios compared with age younger than 55 years were 1.70 for 65- to 74-year-olds (95% CI, 1.19 to 2.43) and 1.34 for those age 75 years and older (95% CI, 0.90 to 2.00). CONCLUSION: Older patients who received chemotherapy had fewer pretherapy events than younger patients and were less likely to receive platinum-based regimens. Nevertheless, older patients had more adverse events during chemotherapy, independent of comorbidity. Potential implicit trade-offs between symptom management and treatment toxicity should be made explicit and additionally studied.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20038726&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1200/JCO.2009.23.8485
dc.subjectAdenocarcinoma
dc.subjectAged
dc.subjectAntineoplastic Combined Chemotherapy Protocols
dc.subjectCarcinoma, Non-Small-Cell Lung
dc.subjectCarcinoma, Squamous Cell
dc.subjectCohort Studies
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHumans
dc.subjectLung Neoplasms
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectNeoplasm Staging
dc.subjectPrognosis
dc.subjectProspective Studies
dc.subjectSurvival Rate
dc.subjectTreatment Outcome
dc.subjectBioinformatics
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleAdverse events among the elderly receiving chemotherapy for advanced non-small-cell lung cancer
dc.typeJournal Article
dc.source.journaltitleJournal of clinical oncology : official journal of the American Society of Clinical Oncology
dc.source.volume28
dc.source.issue4
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/14
dc.identifier.contextkey1287759
html.description.abstract<p>PURPOSE: To describe chemotherapy use and adverse events (AEs) for advanced-stage, non-small-cell lung cancer (NSCLC) in community practice, including descriptions according to variation by age.</p> <p>METHODS: We interviewed patients with newly diagnosed, stages IIIB and IV NSCLC in the population-based cohort studied by the Cancer Care Outcomes Research and Surveillance Consortium, and we abstracted the patient medical records. AEs were medical events occurring during chemotherapy. Using logistic regression, we assessed the association between age and chemotherapy; with Poisson regression, we estimated event rate ratios and adjusted the analysis for age, sex, ethnicity, radiation therapy, stage, histology, and presence and grade of 27 comorbidities.</p> <p>RESULTS: Of 1,371 patients, 58% (95% CI, 55% to 61%) received chemotherapy and 35% (95% CI, 32% to 38%) had AEs. After adjustment, 72% (95% CI, 65% to 79%) of those younger than 55 years and 47% (95% CI, 42% to 52%) of those age 75 years and older received chemotherapy. Platinum-based therapies were less common in the older-age groups. Pretreatment medical event rates were 18.6% for patients younger than 55 years and were only 9.2% for those age 75 years and older (adjusted rate ratio, 0.49; 95% CI, 0.26 to 0.91). In contrast, older adults were more likely to have AEs during chemotherapy. The adjusted rate ratios compared with age younger than 55 years were 1.70 for 65- to 74-year-olds (95% CI, 1.19 to 2.43) and 1.34 for those age 75 years and older (95% CI, 0.90 to 2.00).</p> <p>CONCLUSION: Older patients who received chemotherapy had fewer pretherapy events than younger patients and were less likely to receive platinum-based regimens. Nevertheless, older patients had more adverse events during chemotherapy, independent of comorbidity. Potential implicit trade-offs between symptom management and treatment toxicity should be made explicit and additionally studied.</p>
dc.identifier.submissionpathqhs_pp/14
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages620-7


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