title: Efficacy and tolerability of chemotherapy in elderly patients with advanced oesophago-gastric cancer: A pooled analysis of three clinical trials.
abstract: The aim of this study was to determine the benefits of chemotherapy for oesophago-gastric cancer (OGC) in patients 70 years and above (> or =70) in comparison to younger patients. 1080 patients were enrolled into three randomised controlled trials assessing fluorouracil-based combination chemotherapy. Patients received either a platinum-containing regimen (ECF, MCF), PVI 5-FU (protracted venous infusion of 5-fluorouracil)+/-mitomycin C (MMC), or FAMTX. Of the 1080 patients randomised, 257 (23.8%) were aged > or =70 years. There were no significant differences in the incidence of grades 3/4 toxicity between the two cohorts. Objective and symptomatic response rates, failure-free and overall survival were not significantly different. In a multivariate analysis, independent prognostic factors for survival were performance status and locally advanced disease, not age. Patients > or =70 years with OGC obtained similar benefits from palliative chemotherapy with respect to symptomatic response, tumour regression and survival, without increased toxicities.
authors.affiliation: Section of Medicine, Gastrointestinal Unit, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Trumper
authors.forename: P J
authors.initials: PJ
authors.lastname: Ross
authors.forename: D
authors.initials: D
authors.lastname: Cunningham
authors.forename: A R
authors.initials: AR
authors.lastname: Norman
authors.forename: R
authors.initials: R
authors.lastname: Hawkins
authors.forename: M
authors.initials: M
authors.lastname: Seymour
authors.forename: P
authors.initials: P
authors.lastname: Harper
authors.forename: T
authors.initials: T
authors.lastname: Iveson
authors.forename: M
authors.initials: M
authors.lastname: Nicolson
authors.forename: T
authors.initials: T
authors.lastname: Hickish
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D013274:Stomach Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome