Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan.
Oncology. 2022;100(11):576-582. doi: 10.1159/000527012. Epub 2022 Oct 17.
Adjuvant chemotherapy improves the prognosis of patients with colorectal cancer (CRC) following radical resection. However, the safety and efficacy of oxaliplatin-based chemotherapeutic regimens for elderly patients remains to be elucidated. The aim of the present study was to examine the tolerability and efficacy of adjuvant CAPOX (capecitabine and oxaliplatin) therapy for elderly patients in comparison with young patients.
We examined 138 Japanese patients who received adjuvant CAPOX therapy for high-risk stage II or III CRC between July 2010 and June 2021 at our hospital. Patients were divided according to an age of 70 years. Treatment details of CAPOX therapy were analyzed in association with age. Moreover, prognosis of stage III CRC was compared between the patient groups.
Twenty-three patients (17%) were ≥70 years old. Male patients were predominant in the ≥70 years group (p = 0.006). Patients ≥70 years old had more comorbidities (diabetes, p = 0.014; cardiovascular disease, p < 0.001; renal disease, p = 0.042) than patients <70 years old. There were no age-dependent differences in dose intensity, the number of cycles, or DLTs of CAPOX therapy. CSS and RFS were also similar between the ≥70 and <70 years old patients with stage III CRC.
Adjuvant CAPOX therapy was tolerable in elderly Japanese patients. The prognosis of elderly patients with stage III CRC was similar to that of their younger counterparts. Advanced age itself may not be a contraindication for adjuvant chemotherapy in CRC. Future studies with a larger patient cohort are required to confirm the present results.
辅助化疗可改善根治性切除术后结直肠癌(CRC)患者的预后。然而,对于老年患者,奥沙利铂为基础的化疗方案的安全性和疗效仍有待阐明。本研究旨在比较老年患者与年轻患者接受辅助 CAPOX(卡培他滨和奥沙利铂)治疗的耐受性和疗效。
我们检查了 2010 年 7 月至 2021 年 6 月期间在我院接受高危 II 期或 III 期 CRC 辅助 CAPOX 治疗的 138 名日本患者。根据年龄将患者分为 70 岁。分析 CAPOX 治疗的治疗细节与年龄的关系。此外,比较了两组 III 期 CRC 的预后。
23 名患者(17%)≥70 岁。≥70 岁组中男性患者居多(p=0.006)。≥70 岁的患者比<70 岁的患者有更多的合并症(糖尿病,p=0.014;心血管疾病,p<0.001;肾脏疾病,p=0.042)。CAPOX 治疗的剂量强度、周期数或 DLT 与年龄无关。CSS 和 RFS 在 III 期 CRC 的≥70 岁和<70 岁患者之间也相似。
辅助 CAPOX 治疗在日本老年患者中是耐受的。III 期 CRC 老年患者的预后与年轻患者相似。年龄本身可能不是 CRC 辅助化疗的禁忌症。需要更大的患者队列的未来研究来证实本研究的结果。