Question explored with the scientific record
Is chemotherapy worthwhile for 85 year old women with stage 4 ovarian and lung cancer
The evidence retrieved does not answer the question asked. It contains no study of an 85-year-old woman with stage 4 ovarian and lung cancer receiving chemotherapy.
The evidence covers chemotherapy in ependymoma [1], follow-up monitoring in ovarian cancer [2], toxicity in elderly Korean patients (median age 71, not 85) [3], pediatric solid tumors [4], germ cell tumors in men [5], Medicare claims validation [6], lymphoma genetics [7], recurrent ovarian cancer in younger women (median age 52) [8], colorectal cancer [9], cervical cancer radiotherapy [10], and a pediatric case report [11]. None of these match the specific population and dual-primary scenario in the question.
The closest study [3] found that 25% of patients aged 65-80 experienced significant chemotherapy toxicity, with declines in performance status, daily activities, and cognition. But that group is younger and healthier than an 85-year-old with two stage 4 cancers. The toxicity rate in a truly frail 85-year-old would almost certainly be higher.
My call: the evidence does not support or refute net benefit for this patient. The gap itself matters. Confidence: not clear.
Sources examined 11
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Chemotherapy of Adult Ependymoma
This chapter reviews the chemotherapy treatment options and outcomes for adult patients with ependymoma, highlighting the limited efficacy of various regimens and the need for further research into molecular characteristics and treatment strategies.
DOI: 10.1016/b978-0-12-812100-9.00037-1 -
The follow-up of ovarian cancer
Early detection of recurrent ovarian cancer through CA-125 monitoring, radiologic imaging, or second-look surgery has not demonstrated a survival advantage, supporting observation and selective testing.
DOI: 10.1016/s0093-7754(03)00100-3 -
Toxicities and functional consequences of systemic chemotherapy in elderly Korean patients with cancer: A prospective cohort study using Comprehensive Geriatric Assessment
This study evaluates the functional consequences and identifies risk factors for chemotherapy toxicity in elderly Korean cancer patients using Comprehensive Geriatric Assessment, finding that significant toxicity occurred in 25% of patients and that baseline ECOG performance sta…
DOI: 10.1016/j.jgo.2012.06.002 -
Failure of granulocyte‐macrophage colony‐stimulating factor to reduce febrile neutropenia in children with recurrent solid tumors treated with ifosfamide, carboplatin, and etoposide chemotherapy
In children with relapsed solid tumors treated with ICE chemotherapy, adding GM-CSF shortened neutropenia duration but did not reduce febrile neutropenia-related hospitalizations or improve overall outcomes compared with historical ICE-alone controls.
DOI: 10.1002/mpo.2950230403 -
High-risk germ cell tumors in men high response rate and severe toxicity with cisplatin, vinblastine, bleomycin, and etoposide
This study reports on 10 men with high-risk germ cell tumors treated with a high-dose cisplatin-based regimen (PVeBV), achieving six complete remissions but suffering severe toxicity including three treatment-related deaths from bleomycin-associated pulmonary fibrosis, suggestin…
DOI: 10.1002/1097-0142(19930401)71:7<2351::aid-cncr2820710729>3.0.co;2-h -
Measuring Clinically Significant Chemotherapy-Related Toxicities Using Medicare Claims From Cancer and Leukemia Group B (CALGB) Trial Participants
This study evaluates the validity of Medicare claims data in capturing clinically significant chemotherapy-related toxicities among elderly patients enrolled in Cancer and Leukemia Group B trials, finding that while some toxicities can be identified, the overall accuracy is limi…
DOI: 10.1097/MLR.0b013e31815cecc3 -
Through translational prospective study, the GSTP1 Ile105Val polymorphism emerges as prognostic marker in de novo large B-cell lymphoma patients
This translational prospective study identifies the GSTP1 Ile105Val polymorphism as a prognostic marker influencing toxicity and response to R-CHOP chemotherapy in de novo diffuse large B-cell lymphoma patients.
DOI: 10.1038/bcj.2017.38 -
Daily low-dose oral etoposide for recurrent epithelial ovarian cancer after platinum-based therapy
This study evaluates the efficacy and toxicity of daily low-dose oral etoposide in women with recurrent epithelial ovarian cancer who have previously undergone platinum-based chemotherapy, finding limited response rates and significant complications.
DOI: 10.1080/01443610410001660896 -
The distribution of polymorphic enzymes in colon cancer case
This study evaluates the effectiveness and toxicity of a combination therapy of 5-FU and sodium-folinic acid in patients with metastatic colorectal cancer, revealing a response rate of 50% and highlighting the treatment's feasibility despite some gastrointestinal side effects.
DOI: 10.1016/s0959-8049(99)80695-9 -
EP-1338: Advantages and early outcomes of extended field IMRT for advanced cervical cancer
This study evaluates the efficacy and safety of combining intensity-modulated radiotherapy (IMRT) with three-dimensional conformal brachytherapy in patients with cervical carcinoma, demonstrating promising outcomes with manageable toxicity levels.
DOI: 10.1016/s0167-8140(15)31456-0 -
Interstitial pneumonitis and pleural effusion in a one-year-old child with an abdominal tumor
A pediatric case report of a 1-year-old boy with neuroblastoma who developed fatal interstitial pneumonitis and pleural effusion likely induced by cyclophosphamide therapy, with autopsy-confirmed histopathology and discussion of differential diagnoses.
DOI: 10.1016/S0022-3476(81)80734-2