Adjuvant or Palliative Chemotherapy for Colorectal Cancer in Patients 70 Years or Older

American Society of Clinical Oncology (ASCO) - Tập 17 Số 8 - Trang 2412-2412 - 1999
Răzvan Popescu1, A. Norman2, Paul J. Ross2, Biren Parikh2, David Cunningham2
1Gastrointestinal Unit, Royal Marsden Hospital, London, and Sutton, Surrey, United Kingdom.
2From the Gastrointestinal Unit, Royal Marsden Hospital, London, and Sutton, Surrey, United Kingdom.

Tóm tắt

PURPOSE: The surgical treatment of colorectal cancer (CRC) in elderly patients (age 70 years or older) has improved, but data on adjuvant and palliative chemotherapy tolerability and benefits in this growing population remain scarce. Elderly patients are underrepresented in clinical trials, and results for older patients are seldom reported separately. PATIENTS AND METHODS: Using a prospective database, we analyzed demographics, chemotherapy toxicity, response rates, failure-free survival (FFS), and overall survival (OS) of CRC patients receiving chemotherapy at the Royal Marsden Hospital. The cutoff age was 70 years. RESULTS: A total of 844 patients received first-line chemotherapy with various fluorouracil (5-FU)-containing regimens or raltitrexed for advanced disease, and 543 patients were administered adjuvant, protracted venous infusion 5-FU or bolus 5-FU/folinic acid (FA) chemotherapy. Of the 1,387 patients, 310 were 70 years or older. There was no difference in overall or severe (Common Toxicity Criteria III to IV) toxicity between the two age groups, with the exception of more frequent severe mucositis in older patients receiving adjuvant bolus 5-FU/FA. For patients receiving palliative chemotherapy, no difference in response rates (24% v 29%, P = .19) and median FFS (164 v 168 days) were detected when the elderly were compared with younger patients. Median OS was 292 days for the elderly group and 350 days for the younger patients (P = .04), and 1-year survival was 44% and 48%, respectively. The length of inpatient hospital stay was identical. CONCLUSION: Elderly patients with good performance status tolerated adjuvant and palliative chemotherapy for CRC as well as did younger patients and had similar benefits from palliative chemotherapy.

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Tài liệu tham khảo

10.1002/1097-0142(19950201)75:3<775::AID-CNCR2820750305>3.0.CO;2-D

10.1016/0140-6736(90)91075-L

10.1002/(SICI)1097-0142(19960815)78:4<918::AID-CNCR32>3.0.CO;2-W

10.1093/oxfordjournals.annonc.a010716

10.1038/bjc.1997.492

10.1007/BF02051172

10.1002/bjs.1800750508

10.1007/BF02049704

10.1016/0002-9610(92)90559-A

10.1002/(SICI)1098-2388(199607/08)12:4<219::AID-SSU3>3.0.CO;2-8

10.1002/1097-0142(19941001)74:7+<2208::AID-CNCR2820741737>3.0.CO;2-#

Brower M, Asbury R, Kramer Z, et al: Adjuvant chemotherapy for colorectal cancer in the elderly: Population-based experience. Proc Am Soc Clin Oncol 12:195,1993, (abstr 570)

10.1002/1097-0142(19941001)74:7+<2151::AID-CNCR2820741724>3.0.CO;2-S

O'Connell M Maillard J, Macdonald J, et al: An intergroup trial of intensive course 5FU and low dose leucovorin as surgical adjuvant therapy for high risk colon cancer. Proc Am Soc Clin Oncol 12:190,1993, (abstr 552)

10.1002/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6

10.1002/1097-0142(19950101)75:1<11::AID-CNCR2820750104>3.0.CO;2-N

10.1002/1097-0142(19831201)52:11<1986::AID-CNCR2820521103>3.0.CO;2-7

10.1097/00000421-199608000-00010

10.1200/JCO.1989.7.4.425

10.1200/JCO.1998.16.1.301