First line palliative chemotherapy in elderly patients with advanced soft tissue sarcoma.
BACKGROUND
The efficacy and toxicity of first line palliative chemotherapy for soft tissue sarcomas (STS) in the elderly is poorly described.


METHODS
Patients over the age of 65 years receiving first line chemotherapy for advanced non-GIST STS January 1998 - January 2012 at the Royal Marsden Hospital were identified. Data regarding survival and predictive factors were collected retrospectively.


RESULTS
120 patients (52 females) with a median age of 72 (range 65-83) were treated. The most common histological subtypes were undifferentiated sarcoma (30%), leiomyosarcoma (27%), angiosarcoma (14%). 42% of patients had high grade tumours. 70% of patients had metastatic disease at presentation; lung metastasis being the most common disease site (72%). 80% received single agent chemotherapy, mostly with doxorubicin (60%). The median number of cycles was 2 (IQR 3). A partial response was reported in 20% of patients with disease stabilisation in a further 20%. 38% of patients were hospitalised for chemotherapy related toxicity. The median overall survival (OS) was 6.5 months (95% CI 4.7-8.3). Anaemia, lymphopenia, hypoalbuminemia, sarcoma subtype and co-morbidities were predictive for overall survival.


CONCLUSIONS
The overall survival for elderly patients with STS is poor but several predictive factors have been identified. Hospital admissions for chemotherapy related toxicity are common.
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Nadia
N
Yousaf
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Samuel
S
Harris
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Juan
J
Martin-Liberal
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Susannah
S
Stanway
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Mark
M
Linch
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Maria
M
Ifijen
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Omar
O
Al Muderis
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Komel
K
Khabra
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Cyril
C
Fisher
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Jonathan
J
Noujaim
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Ian
I
Judson
The Sarcoma Unit, The Royal Marsden Hospital, Fulham Road, London, SW3 6JJ UK.
Charlotte
C
Benson
Chemotherapy; Elderly; Metastatic; Sarcoma