Medical Oncology, San Carlo Hospital, Potenza, Italy.
Medical Oncology, Santa Maria Nuova IRCCS Hospital, Reggio Emilia, Italy.
J Geriatr Oncol. 2018 May;9(3):243-248. doi: 10.1016/j.jgo.2018.01.009. Epub 2018 Feb 9.
The influence of age (<70 years and ≥70 years) was retrospectively studied on the quality of life (QoL), incidence of side effects (including skin reactions) and efficacy of chemotherapy plus cetuximab in patients with KRAS wild type (WT) metastatic colorectal cancer (mCRC).
225 patients of the Observed study (PS 0-1) were retrieved based on age (< 70 and ≥70 years) and evaluated through EORTC QLQ-C30 and DLQI questionnaires.
The two patient groups (141 < 70 and 84 ≥ 70 years, respectively) were balanced with no differences in any of the clinical and pathological characteristics considered. Both groups underwent similar type of first-line chemotherapy plus cetuximab, treatment duration and compliance. Cetuximab therapy caused similar incidence of side effects and impact on QoL in older and younger patients. No difference was observed in progression free survival (PFS) and in disease control rates between the two patient populations. Median overall survival (OS) was higher in patients <70 (27 months, 95% CI: 22.7-31.27) than in patients ≥70 (19 months, 95% CI: 14.65-23.35) (p = 0.002), which is likely due to higher proportions of metastatic resection (27.0% vs 8.3%; p = 0.001) and utilization of second-line therapy in younger group (58.9% vs 42.9%; p = 0.028).
The current data suggest that fit older patients with mCRC can be safely treated with a cetuximab-based therapy, as QoL and safety profile do not seem to be affected by age. In addition, age did not impact the choice of chemotherapy to be associated to cetuximab and treatment compliance.
本研究回顾性分析了年龄(<70 岁和≥70 岁)对 KRAS 野生型(WT)转移性结直肠癌(mCRC)患者生活质量(QoL)、不良反应(包括皮肤反应)发生率和化疗联合西妥昔单抗疗效的影响。
根据年龄(<70 岁和≥70 岁),从观察性研究(PS 0-1)中检索了 225 例患者,并通过 EORTC QLQ-C30 和 DLQI 问卷进行评估。
两组患者(分别为 141 例<70 岁和 84 例≥70 岁)在任何临床和病理特征方面均无差异。两组均接受了类似的一线化疗联合西妥昔单抗、治疗持续时间和依从性。西妥昔单抗治疗在老年和年轻患者中引起的不良反应发生率和对 QoL 的影响相似。两组患者的无进展生存期(PFS)和疾病控制率无差异。<70 岁患者的中位总生存期(OS)(27 个月,95%CI:22.7-31.27)高于≥70 岁患者(19 个月,95%CI:14.65-23.35)(p=0.002),这可能是由于年轻组中有更高比例的转移性切除术(27.0%比 8.3%;p=0.001)和二线治疗的应用(58.9%比 42.9%;p=0.028)。
目前的数据表明,身体状况良好的老年 mCRC 患者可以安全地接受西妥昔单抗为基础的治疗,因为 QoL 和安全性似乎不受年龄的影响。此外,年龄并不影响与西妥昔单抗联合应用的化疗选择和治疗依从性。