Prolongation of survival and improvement in performance status following palliative chemotherapy in gastrointestinal cancer patients with a poor performance status.
BACKGROUND
The prognosis of advanced gastrointestinal cancer, especially in patients with poor performance status (PS), is generally dismal. Patients with PS 3-4 are almost ineligible for participation in clinical studies.


METHODS
From June 2000 to February 2007, 116 patients with poor PS (PS 3 = 73 and PS 4 = 43) were treated with chemotherapy. Retrospective analysis was performed.


RESULTS
Of the 107 patients with at least one measurable lesion, a partial response was obtained in 15 patients (14.0%). Of 65 patients with ascites and/or pleural effusion, 12 patients achieved decreased fluid accumulation. A decline in tumor markers was observed in 30 patients. As a result, 38 patients (32.7%) achieved tumor response, a decrease in fluid accumulation or a decline in tumor markers (responders), which resulted in a survival benefit compared to the other 78 patients without effect (6.9 vs. 2.2 months, p < 0.001). PS improvement was seen in 16 patients (13.8%).


CONCLUSIONS
The results suggest that chemotherapy may be beneficial in gastrointestinal cancer patients with poor PS, as demonstrated by a certain degree of improvement in PS and survival in responders. Further study is required to confirm the benefit of chemotherapy in this patient population.
Shitara
Kohei
K
Department of Medical Oncology, Misawa City Hospital, Misawa, Japan. Kouheis0824@yahoo.co.jp
Munakata
Masaki
M
Kasai
Masaharu
M
Muto
Osamu
O
Sakata
Yuh
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D006801:Humans; D017567:Karnofsky Performance Status / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate