Lim Kyu-Hyoung, Lee Hui-Young, Park Sung Bae, Song Seo-Young
Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon, South Korea.
Oncology. 2017;93(2):115-121. doi: 10.1159/000471767. Epub 2017 Apr 27.
The aim of this study was to assess the feasibility of a modified FOLFOX regimen as first-line treatment in elderly patients with metastatic gastric cancer (GC) or colorectal cancer (CRC).
We included chemotherapy-naïve patients over 80 years old with metastatic GC or CRC in our study. From September 2008 to November 2014, 28 consecutive patients were enrolled and treated with modified FOLFOX.
The study population consisted of an equal number of GC and CRC patients. The median age was 82.2 years in the GC group and 81.1 years in the CRC group. The total number of administered cycles was 89 (with a median of 6 per patient) in the GC group and 112 (with a median of 8 per patient) in the CRC group. Median progression-free survival (PFS) and overall survival (OS) were 5.4 and 6.6 months in the GC group and 7.3 and 8.1 months in the CRC group, respectively. There was no significant difference in PFS (p = 0.941) and OS (p = 0.238) between the GC and the CRC group. The 1-year survival rates were 35.7% with GC and 42.9% with CRC. Common grade 3/4 hematology toxicities were neutropenia (10.7%) and anemia (14.3%). Salvage chemotherapy was administered to 1 patient with GC and 7 patients with CRC.
The modified FOLFOX regimen can be cautiously considered as a first-line treatment option in extremely elderly patients with metastatic GC or CRC.
本研究旨在评估改良FOLFOX方案作为老年转移性胃癌（GC）或结直肠癌（CRC）一线治疗方案的可行性。
我们纳入了年龄超过80岁、初治的转移性GC或CRC患者。从2008年9月至2014年11月，连续纳入28例患者并接受改良FOLFOX方案治疗。
研究人群中GC和CRC患者数量相等。GC组的中位年龄为82.2岁，CRC组为81.1岁。GC组的给药周期总数为89个（中位值为每位患者6个），CRC组为112个（中位值为每位患者8个）。GC组的中位无进展生存期（PFS）和总生存期（OS）分别为5.4个月和6.6个月，CRC组分别为7.3个月和8.1个月。GC组和CRC组之间的PFS（p = 0.941）和OS（P = 0.238）无显著差异。GC组和CRC组的1年生存率分别为35.7%和42.9%。常见的3/4级血液学毒性为中性粒细胞减少（10.7%）和贫血（14.3%）。1例GC患者和7例CRC患者接受了挽救性化疗。
改良FOLFOX方案可谨慎地考虑作为极老年转移性GC或CRC患者的一线治疗选择。
