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First-Line Mono-Chemotherapy in Frail Elderly Patients with Metastatic Colorectal Cancer

  • Varol, Umut (Katip Celebi University Ataturk, Izmir Tepecik Training and Research Hospital) ;
  • Dirican, Ahmet (Katip Celebi University Ataturk, Izmir Tepecik Training and Research Hospital) ;
  • Yildiz, Ibrahim (Katip Celebi University Ataturk, Izmir Tepecik Training and Research Hospital) ;
  • Oktay, Esin (Adnan Menderes University Faculty of Medicine) ;
  • Degirmenci, Mustafa (Medical Oncology Clinic, Izmir Tepecik Training and Research Hospital) ;
  • Alacacioglu, Ahmet (Katip Celebi University Ataturk, Izmir Tepecik Training and Research Hospital) ;
  • Barutca, Sabri (Adnan Menderes University Faculty of Medicine) ;
  • Karabulut, Bulent (Department of Internal Medicine, Division of Medical Oncology, Ege University Faculty of Medicine) ;
  • Uslu, Ruchan (Department of Internal Medicine, Division of Medical Oncology, Ege University Faculty of Medicine)
  • Published : 2014.04.01

Abstract

Background: Unlike for fit elderly metastatic colorectal cancer (mCRC) patients, general approaches to initial treatment for the frail older mCRC patients are not clear. Our aim was to evaluate the efficiency and safety of first-line single-agent treatment in one such group. Materials and Methods: We retrospectively evaluated mCRC patients aged 70 or older with an Eastern Cooperative Oncology Group performance score of 2. They had no prior treatment and underwent first-line single-agent capecitabine or other monotherapies until disease progression or unacceptable toxicity. Results: Thirty-six patients were included. Most (n:28, 77.8%) were treated with capecitabine. One patient achieved a complete response and 5 patients had a partial response for an overall response rate of 16.6%. Twelve patients (33.3%) remained stable. Median progression free survival was 5 months (confidence interval (CI), %; 3.59-6.40) and median overall survival was 10 months (95 CI%; 8.1-11.8). Grade 3-4 toxicity was found in 6 patients (16.6%). Febrile neutropenia was not observed and there were no toxicity-associated deaths. Conclusions: Capecitabine is a safe chemotherapeutic agent with moderate activity for first-line treatment of older metastatic colorectal cancer patients with limited performance status.

Keywords

Capecitabine;monotherapy;elderly;colorectal cancer;metastasis

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