While older individuals with high-risk endometrial cancer (EC) are less likely to desire chemotherapy than younger patients, perceived benefits vary in this age group, according to findings recently published in Maturitas.
“Older patients would, more often than younger patients, never choose chemotherapy regardless of the survival benefit, which has also been shown by others in colorectal cancer and breast cancer,” the authors wrote.
A previous clinical trial, PORTEC-3, found that among patients receiving radiotherapy, chemotherapy significantly improved survival. However, chemotherapy resulted in more side effects that have the potential to negatively impact quality of life.
The authors analyzed data from the PRETEC-2 study, which surveyed women with EC to understand their opinions on chemotherapy. Of the 453 patients invited to complete the survey, 171 (37.7%) completed the entire questionnaire. Participants had a median age of 60 years. Older individuals were less likely to have received adjuvant chemotherapy, which is administered after surgery to destroy remaining cancer cells.
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While participants younger than 60 years would choose chemotherapy if it provided a median survival benefit of 5%, those aged 60 to 69 required an 8% benefit, and those aged 70 or older required a 15% benefit. The oldest age group had the largest variability in minimally desired survival benefit, though.
Additionally, 7.7% of participants younger than 60 would never choose chemotherapy, compared to 11.8% of those aged 60 to 69 and 21.9% of those aged 70 or older.
Older patients were least likely to consider survival benefit “very important,” but there was no significant difference between age groups. Older participants were more concerned about side effects, changes in functioning and tingling or numbness that could result from chemotherapy. Older participants displayed the greatest variability when it came to opinions surrounding tingling and numbness.
“Clinicians should therefore be aware of the heterogeneity in preferences of older patients and discuss their needs, preferences and motivation for choosing or refusing adjuvant chemotherapy as part of a shared decision-making process,” the authors concluded.
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