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

• Published in: European journal of cancer (1990) 2006-05, Vol.42 (7), p.827-834
• Main Authors: Trumper, M., Ross, P.J., Cunningham, D., Norman, A.R., Hawkins, R., Seymour, M., Harper, P., Iveson, T., Nicolson, M., Hickish, T.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Chemotherapy; Disease-Free Survival; Elderly; Esophageal Neoplasms - drug therapy; Female; Humans; Male; Medical sciences; Oesphago-gastric; Pharmacology. Drug treatments; Randomized Controlled Trials as Topic; Stomach Neoplasms - drug therapy; Treatment Outcome; Tumors
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2005.08.044

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.