Provisional Clinical Opinions Recommended by the Supportive and Palliative Care Working Group for Vulnerable Elderly Patients with Colorectal Cancer

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  • 「プレフレイル高齢大腸がん患者のための臨床的提言」支持・緩和医療に関する提言

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Abstract

<p>Fit elderly patients with cancer can tolerate standard therapy with anticipated efficacy similar to non-elderly patients; however, frail patients are unlikely to tolerate such toxic treatment due to poor general condition, in which case only the best supportive care is indicated. Prefrail patients, in a condition between fit and frail, can tolerate only less-intensive cancer therapy due to their reduced general condition, and managing these patients with confidence is difficult as no guideline is available due to the paucity of evidence. Here, provisional clinical opinions recommended by the Supportive and Palliative Care Working Group are provided for vulnerable elderly patients with colorectal cancer. We have focused on bowel obstruction and chemotherapy-induced peripheral neuropathy and provided answers to questions on important topics such as the following recommendations from multi-occupational teams, including physicians and nurses, occupational therapists and patients' family. For bowel obstruction, “Should insertion of a mechanical stent be prioritized for patients who are poor candidates for surgical procedure?”, “What kind of issues exist for colostomy placement in prefrail elderly patients with colorectal cancer?” and “What should be considered for prefrail elderly patients with colorectal cancer who receive oxaliplatin-based chemotherapy?”</p>

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