Efficacy and tolerability of chemotherapy in elderly patients with advanced oesophago-gastric cancer: a pooled analysis of three clinical trials

Trumper, M., Ross, P.J., Cunningham, D., Norman, A.R., Hawkins, R., Seymour, M., Harper, P., Iveson, T., Nicolson, M. and Hickish, T. (2006) Efficacy and tolerability of chemotherapy in elderly patients with advanced oesophago-gastric cancer: a pooled analysis of three clinical trials. European Journal of Cancer, 42 (7), 827-834. (doi:10.1016/j.ejca.2005.08.044).

Abstract

The aim of this study was to determine the benefits of chemotherapy for oesophago-gastric cancer (OGC) in patients 70 years and above ( ≥ 70) in comparison to younger patients. 1080 patients were enrolled into three randomised controlled trials assessing fluorouracil-based combination chemotherapy. Patients received either a platinum-containing regimen (ECF, MCF), PVI 5-FU (protracted venous infusion of 5-fluorouracil) ± mitomycin C (MMC), or FAMTX. Of the 1080 patients randomised, 257 (23.8%) were aged ≥ 70 years. There were no significant differences in the incidence of grades 3/4 toxicity between the two cohorts. Objective and symptomatic response rates, failure-free and overall survival were not significantly different. In a multivariate analysis, independent prognostic factors for survival were performance status and locally advanced disease, not age. Patients ≥ 70 years with OGC obtained similar benefits from palliative chemotherapy with respect to symptomatic response, tumour regression and survival, without increased toxicities.

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Contributors

Author: T. Iveson

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