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Pharmacology of Chemotherapy in the Older Cancer Patient.

BACKGROUND: The incidence of cancer among the elderly population is increasing. The aging process can deplete functional reserve of many organ systems and thus affects the treatment goals for this age-group. METHODS: The pharmacologic consequences of the aging process on elderly cancer patients are reviewed, and guidelines are suggested for assessing and treating this patient population with antitumor drugs. RESULTS: Individualized management of the older cancer patient reflects the results of a comprehensive geriatric assessment. Factors that affect treatment decisions include estimates of the extent of treatment toxicity, the impact of treatment on quality of life, estimates of life expectancy, and the influence of age on pharmacokinetic parameters. CONCLUSIONS: Management of older patients with cancer includes individual assessments that consider the effects of aging on the pharmacodynamics, therapies, and complications of treatment for this population. Treatment can be made safer and more effective by adjusting chemotherapy dosage, maintaining hemoglobin levels, and using hemopoietic growth factors when appropriate.