Department of Medical Oncology, VieCuri Medical Centre, Venlo, the Netherlands.
Ann Oncol. 2013 Apr;24(4):974-9. doi: 10.1093/annonc/mds576. Epub 2012 Nov 7.
We evaluated which patient factors were associated with treatment tolerance and outcome in elderly colon cancer patients.
Population-based data from five regions included in the Netherlands Cancer Registry were used. Patients with resected stage III colon cancer aged ≥75 years diagnosed in 1997-2004 who received adjuvant chemotherapy (N = 216) were included as well as a random sample (N = 341) of patients who only underwent surgery.
The most common motives for withholding adjuvant chemotherapy were a combination of high age, co-morbidity and poor performance status (PS, 43%) or refusal by the patient or family (17%). In 57% of patients receiving chemotherapy, adaptations were made in treatment regimens. Patients who received adjuvant chemotherapy developed more complications (52%) than those with surgery alone (41%). For the selection of patients who had survived the first year after surgery, receiving adjuvant chemotherapy resulted in better 5-year overall survival (52% versus 34%), even after adjustment for differences in age, co-morbidity and PS.
Despite high toxicity rates and adjustments in treatment regimens, elderly patients who received chemotherapy seemed to have a better survival. Prospective studies are needed for evaluating which patient characteristics predict the risks and benefits of adjuvant chemotherapy in elderly colon cancer patients.
我们评估了哪些患者因素与老年结肠癌患者的治疗耐受性和结局相关。
使用来自荷兰癌症登记处的五个地区的基于人群的数据。纳入了 1997-2004 年间诊断为 III 期结肠癌且年龄≥75 岁并接受辅助化疗的患者（n=216），以及仅接受手术的患者的随机样本（n=341）。
拒绝辅助化疗的最常见原因是高龄、合并症和较差的体能状态（PS，43%）或患者或家属拒绝（17%）。接受化疗的患者中有 57%调整了治疗方案。接受辅助化疗的患者发生更多并发症（52%），而仅接受手术的患者为 41%。对于选择手术后存活一年的患者，接受辅助化疗可获得更好的 5 年总生存率（52% vs 34%），即使在校正了年龄、合并症和 PS 的差异后也是如此。
尽管毒性反应率较高且治疗方案有所调整，但接受化疗的老年患者似乎生存更好。需要前瞻性研究来评估哪些患者特征可预测辅助化疗对老年结肠癌患者的风险和获益。
