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Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age
The incidence of neuroendocrine neoplasia (NEN) is higher in individuals ≥70 years of age (elderly) who are underrepresented in clinical trials because of comorbidities and low performance status. We retrospectively analyzed the outcome of elderly patients with metastatic NEN (mNEN). Comorbidities w...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bioscientifica Ltd
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311458/ https://www.ncbi.nlm.nih.gov/pubmed/30530877 http://dx.doi.org/10.1530/EC-18-0478 |
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author | Bongiovanni, Alberto Recine, Federica Foca, Flavia Fausti, Valentina Riva, Nada Fabbri, Greta Severi, Stefano Liverani, Chiara De Vita, Alessandro Spadazzi, Chiara Miserocchi, Giacomo Mercatali, Laura Amadori, Dino Ibrahim, Toni |
author_facet | Bongiovanni, Alberto Recine, Federica Foca, Flavia Fausti, Valentina Riva, Nada Fabbri, Greta Severi, Stefano Liverani, Chiara De Vita, Alessandro Spadazzi, Chiara Miserocchi, Giacomo Mercatali, Laura Amadori, Dino Ibrahim, Toni |
author_sort | Bongiovanni, Alberto |
collection | PubMed |
description | The incidence of neuroendocrine neoplasia (NEN) is higher in individuals ≥70 years of age (elderly) who are underrepresented in clinical trials because of comorbidities and low performance status. We retrospectively analyzed the outcome of elderly patients with metastatic NEN (mNEN). Comorbidities were summarized by Charlson Comorbidity Index (CCI), Kaplan–Meier method was applied to estimate overall survival (OS) and Cox’s proportional hazard model was used to assess the impact of known prognostic factors. We retrieved data on 145 mNEN patients aged ≥70 years seen at our center from June 2007 to March 2016. Fifty-six (38.6%) were aged ≥75 years. ECOG PS was 0 in 45.7% of cases and CCI was 0 in 41.0% and 1 in 37.4%. A total of 75.4% of patients had grade (G)1/G2 NEN and 24.6%, G3. Octreoscan/Gallium PET/CT and FDG-PET/CT were positive in 94.2% and 70.3% of cases, respectively. Median follow-up was 72.3 (53.2–85.1) months. Seventy-nine patients received first-line somatostatin analogs (SSA), 23 peptide receptor radionuclide therapy (PRRT) and 36 chemotherapy (CHT). Seven did not undergo first-line therapy and 102 received more than one line. Median overall survival (mOS) was 5.1 years (95% CI: 3.4–6.6). No differences in mOS were seen according to CCI. First-line PRRT patients had a mOS of 6.5 years (95% CI: 3.3–not reached (NR)), SSA 5.7 years (95% CI: 4.2–7) and CHT 5.9 years (95% CI: 0.4–NR). mOS in CHT-treated G3 patients was 1.5 years (1.0–2.5). ECOG PS and FDG PET/CT were identified as independent prognostic factors. Results suggest that the above treatments positively impacted OS in elderly mNEN patients, including those aged ≥75 years. |
format | Online Article Text |
id | pubmed-6311458 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Bioscientifica Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-63114582019-01-03 Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age Bongiovanni, Alberto Recine, Federica Foca, Flavia Fausti, Valentina Riva, Nada Fabbri, Greta Severi, Stefano Liverani, Chiara De Vita, Alessandro Spadazzi, Chiara Miserocchi, Giacomo Mercatali, Laura Amadori, Dino Ibrahim, Toni Endocr Connect Research The incidence of neuroendocrine neoplasia (NEN) is higher in individuals ≥70 years of age (elderly) who are underrepresented in clinical trials because of comorbidities and low performance status. We retrospectively analyzed the outcome of elderly patients with metastatic NEN (mNEN). Comorbidities were summarized by Charlson Comorbidity Index (CCI), Kaplan–Meier method was applied to estimate overall survival (OS) and Cox’s proportional hazard model was used to assess the impact of known prognostic factors. We retrieved data on 145 mNEN patients aged ≥70 years seen at our center from June 2007 to March 2016. Fifty-six (38.6%) were aged ≥75 years. ECOG PS was 0 in 45.7% of cases and CCI was 0 in 41.0% and 1 in 37.4%. A total of 75.4% of patients had grade (G)1/G2 NEN and 24.6%, G3. Octreoscan/Gallium PET/CT and FDG-PET/CT were positive in 94.2% and 70.3% of cases, respectively. Median follow-up was 72.3 (53.2–85.1) months. Seventy-nine patients received first-line somatostatin analogs (SSA), 23 peptide receptor radionuclide therapy (PRRT) and 36 chemotherapy (CHT). Seven did not undergo first-line therapy and 102 received more than one line. Median overall survival (mOS) was 5.1 years (95% CI: 3.4–6.6). No differences in mOS were seen according to CCI. First-line PRRT patients had a mOS of 6.5 years (95% CI: 3.3–not reached (NR)), SSA 5.7 years (95% CI: 4.2–7) and CHT 5.9 years (95% CI: 0.4–NR). mOS in CHT-treated G3 patients was 1.5 years (1.0–2.5). ECOG PS and FDG PET/CT were identified as independent prognostic factors. Results suggest that the above treatments positively impacted OS in elderly mNEN patients, including those aged ≥75 years. Bioscientifica Ltd 2018-12-07 /pmc/articles/PMC6311458/ /pubmed/30530877 http://dx.doi.org/10.1530/EC-18-0478 Text en © 2018 The authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Research Bongiovanni, Alberto Recine, Federica Foca, Flavia Fausti, Valentina Riva, Nada Fabbri, Greta Severi, Stefano Liverani, Chiara De Vita, Alessandro Spadazzi, Chiara Miserocchi, Giacomo Mercatali, Laura Amadori, Dino Ibrahim, Toni Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age |
title | Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age |
title_full | Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age |
title_fullStr | Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age |
title_full_unstemmed | Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age |
title_short | Metastatic neuroendocrine neoplasia treatments in patients over 70 years of age |
title_sort | metastatic neuroendocrine neoplasia treatments in patients over 70 years of age |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311458/ https://www.ncbi.nlm.nih.gov/pubmed/30530877 http://dx.doi.org/10.1530/EC-18-0478 |
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