Masters Degrees (Radiation Oncology)

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Browsing Masters Degrees (Radiation Oncology) by browse.metadata.advisor "Fourie, Anna Elizabeth"

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    A retrospective analysis of toxicity and outcomes following chemotherapy for the older population at a single institution
    (Stellenbosch : Stellenbosch University, 2018-03) Pupwe, George; Fourie, Anna Elizabeth; Akudugu, John M.; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Medical Imaging and Clinical Oncology. Radiation Oncology.
    ENGLISH SUMMARY: Introduction: Surgical treatment of colorectal cancer (CRC) in elderly patients has improved, but data on adjuvant and palliative chemotherapy tolerability and benefits in this growing population remains scarce. The elderly population is mostly underrepresented in clinical trials and results for this group of patients are seldom reported separately. Patients and method: Using a retrospective study, we analyzed demographics, compared toxicities in the age groups < 70 years and ≥ 70 years in colorectal cancer patients at Tygerberg Hospital (South Africa). We assessed tumor related mortality, progression free survival (PFS) and overall survival (OS) including predictive factors of OS. Results: A total of 50 patients received either adjuvant or palliative chemotherapy. Different chemotherapy regimens were used. There was no difference in overall or severe (Common Toxicity Criteria Grades 3-4) toxicity in both age groups. Out of the 50 patients, 8 (16%) had Grade 3-4 toxicity. Of these 4 (15%) were < 70years, 4 (17%) were ≥ 70 years. The progression free survival (PFS) and overall survival (OS) were measured using Kaplan-Meier curves. The mean follow-up time was 47.5 months (range: 14.4-80.8 months, 95% CI 41.5-53.5 months). The 5-year overall survival rate for Stage II&III patients <70 years and ≥70 years were 80.9% and69.5%, respectively, and not significantly different; P=0.5156; HR=0.65 (95% CI: 0.17-2.41). Also, no statistically significant difference emerged between the 5-year progression free survival rates of 70.7% and 58.8%; P=0.4920; HR=0.68 (95% CI: 0.23-2.04). For Stage IV patients, there were no significant differences in survival in both groups. There were no survivors beyond 40 months. Median survival rates were similar at 16.3 months (for < 70 years) and 15.9 months (for ≥ 70 years); P=0.8105; HR=1.14(95% CI: 0.35-3.81). There were also no progression free survivors beyond 23 months. Median PF survival rates were 11.1 months (for < 70 years) and 13.5 months (for ≥ 70 years), and were not significantly different; P=0.1743; HR=1.99 (95% CI: 0.66-9.67). Weight loss and performance status (PS) were evaluated as potential predictive factors of OS. For Stage II&III patients of <70 and ≥70 years of age, 68 and 84% of patients presented with a weight loss of <5%, respectively. The corresponding proportions of Stage IV patients were 75 and 100%. Also, 84 and 100% of Stage II&III patients <70 and ≥70 years, respectively, had a PS of 1. All Stage IV patients had a PS of 1. Conclusion: “Fit” elderly patients benefit, at least to the same extent, from adjuvant and palliative chemotherapy as younger patients in this cohort. Therefore, standardized adjuvant and palliative chemotherapy could be offered to elderly patients and they should not be excluded from clinical trials.