title: Toxicity of oxaliplatin plus fluorouracil/leucovorin adjuvant chemotherapy in elderly patients with stage III colon cancer: a population-based study.
abstract: BACKGROUND
  Results concerning the side effects of oxaliplatin associated with fluorouracil and leucovorin (FOLFOX) in older patients are controversial. The objective of this study was to assess the use and the toxicity of FOLFOX in patients aged 70 years and older as administered in current practice.
  
  
  METHODS
  Among 305 stage III colon cancers registered in a well-defined population in Burgundy between 2004 and 2009, 210 had adjuvant chemotherapy, including 156 with FOLFOX. The cumulated rates of toxicity were calculated by using the Kaplan-Meier method. The risks of overall toxicity and of severe toxicity (grade 3 or 4) in patients less than 70 years and in older patients were compared by using a Cox model.
  
  
  RESULTS
  There was no difference between the group of the patients less than 70 years and the older age group for the cumulative incidence of hematologic, neurologic, digestive, and general toxicity. There was also no difference between the two groups for the severity of side effects (grade 3 or 4, 31.4 vs. 39.0 %; p = 0.576). The multivariate analysis indicated after adjustment on sex and the Charlson comorbidity score that there was no difference between the two age groups for toxicity (hazard ratio = 1.28; 95 % CI 0.68-2.41; p = 0.439).
  
  
  CONCLUSIONS
  Cancer registries can be used to evaluate the toxicity of chemotherapy at the population level. Tolerance to the FOLFOX regimen among elderly patients did not significantly differ from that in younger patients. This treatment should be considered regardless of patients' age alone, but consideration should be given to the capacity of patients to tolerate adverse events.
authors.affiliation: Digestive Cancer Registry of Burgundy, INSERM U866, University Hospital, University of Burgundy, Dijon, France.
authors.forename: Samia
authors.initials: S
authors.lastname: Hamza
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bouvier
authors.forename: Fabien
authors.initials: F
authors.lastname: Rollot
authors.forename: Côme
authors.initials: C
authors.lastname: Lepage
authors.forename: Jean
authors.initials: J
authors.lastname: Faivre
authors.forename: Laurent
authors.initials: L
authors.lastname: Bedenne
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D004066:Digestive System Diseases / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006402:Hematologic Diseases / Q000139:chemically induced / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D009367:Neoplasm Staging; D009422:Nervous System Diseases / Q000139:chemically induced / Q000453:epidemiology*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D011379:Prognosis; D015996:Survival Rate
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil