Adjuvant chemotherapy in elderly patients (≥75 yr) completely resected for colon cancer stage III compared to younger patients

Toxicity and prognosis

Abstract

Purpose

To compare benefits and risks to adjuvant chemotherapy following complete resection of nodepositive colon cancer stage III for patients aged ≥75 yr and younger.

Method

A retrospective study compared recurrence-free and overall survival, toxicity, and dose intensity of adjuvant bolus 5-FU according to the Mayo regimen chemotherapy in consecutive patients aged 19–74 (n=203) and ≥75 yr (n=24).

Results

The estimated 5-yr proportional survival rates were 0.65 for patients age less than 75 yr compared to 0.65 (p=0.96) for elderly. The frequencies of anemia (0%), thrombocytopenia (0%), leukopenia (4%), infection *8%), vomiting (0%), mucositis (17%), diarrhea (13%) CTC grade 3 or 4 toxicity in elderly patients were not significantly different from that in younger patients (p>0.05). Significantly more elderly (8%) had a decline in performance status to grade 3 or 4, as compared to younger patients (4%) (p=0.002). 5-FU dose reduction was necessary for significantly more elderly (51%) as compared to younger patients (28%) (p=0.02), and fewer elderly (54%) completed the scheduled six treatment courses as compared to younger patients (82%) (p=0.05).

Conclusions

Adjuvant 5-FU chemotherapy should be considered for elderly patients aged ≥75 yr in good performance at high risk of recurrence of colon carcinoma after resection.

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Correspondence to Søren Astrup Jensen MD, Ph D.

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Jensen, S.A., Vilmar, A. & Sørensen, J.B. Adjuvant chemotherapy in elderly patients (≥75 yr) completely resected for colon cancer stage III compared to younger patients. Med Oncol 23, 521–531 (2006). https://doi.org/10.1385/MO:23:4:521

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Key Words

  • Colonic neoplasms
  • chemotherapy
  • adjuvant
  • fluorouracil
  • aged
  • disease-free survival
  • adverse effects