title: Outcomes in elderly patients treated with a single-agent or combination regimen as first-line chemotherapy for recurrent or metastatic gastric cancer.
abstract: BACKGROUND
  Palliative chemotherapy is used to prolong survival among elderly patients with inoperable gastric cancer (GC). We analyzed differences between single and combination first-line palliative chemotherapy among these patients.
  
  
  METHODS
  Included patients were >70 years old and were treated for GC at four clinical centers of the Catholic University of Korea. Baseline characteristics, the first-line chemotherapy regimen, treatment responses, toxicities, progression-free survival (PFS), and overall survival (OS) were evaluated.
  
  
  RESULTS
  Between 2005 and 2012, 178 > 70-year-old patients with GC received palliative chemotherapy using single or combination regimens. Median ages were 77 years (range 71-89) in the single regimen group (SG, 70 patients) and 73 years (range 71-81) in the combination group (CG, 108 patients). Patients in the SG received S-1 or capecitabine. The most common regimen in the CG was platinum combined with fluorouracil. The most common response in both groups was stable disease (SG, 45.7 %; CG, 48.1 %). In the SG and CG, median PFS times were 4.4 months (95 % confidence interval [CI] 2.85-5.95) and 4.1 months (95 % CI 2.62-5.57; P = 0.295), respectively; median OS times were 6.6 months (95 % CI 4.17-9.08) and 7.6 months (95 % CI 5.50-9.69; P = 0.782), respectively. Hematologic (P < 0.001) and non-hematologic toxicities (P < 0.001) were more frequent in the CG. The most common causes of chemotherapy cessation were disease progression in the SG and decreased performance status in the CG.
  
  
  CONCLUSIONS
  Single-agent treatment should be considered a first-line palliative chemotherapy option for elderly patients with GC.
authors.affiliation: Division of Oncology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Der Sheng
authors.initials: DS
authors.lastname: Sun
authors.forename: Eun Kyoung
authors.initials: EK
authors.lastname: Jeon
authors.forename: Hye Sung
authors.initials: HS
authors.lastname: Won
authors.forename: Ji Chan
authors.initials: JC
authors.lastname: Park
authors.forename: Byoung Young
authors.initials: BY
authors.lastname: Shim
authors.forename: Suk Young
authors.initials: SY
authors.lastname: Park
authors.forename: Young Seon
authors.initials: YS
authors.lastname: Hong
authors.forename: Hoon Kyo
authors.initials: HK
authors.lastname: Kim
authors.forename: Yoon Ho
authors.initials: YH
authors.lastname: Ko
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000069287:Capecitabine / Q000008:administration & dosage / Q000009:adverse effects; D004338:Drug Combinations; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D053208:Kaplan-Meier Estimate; D002955:Leucovorin; D008297:Male; D009944:Organoplatinum Compounds; D010094:Oxonic Acid / Q000627:therapeutic use; D010166:Palliative Care; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D005641:Tegafur / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D009944:Organoplatinum Compounds; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil
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