title: Safety and efficacy of dose-dense chemotherapy with TCF regimen in elderly patients with locally advanced or metastatic gastric cancer.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of dose-dense TCF in elderly (≥65 years) compared to younger patients.
  
  
  METHODS
  Safety and efficacy data relative to 119 consecutive patients with locally advanced or metastatic gastric cancer treated at our institution and enrolled in different phase II trials were retrospectively collected. All patients were treatment-naive and received docetaxel 70 mg/m2 day 1, cisplatin 60 mg/m2 day 1, l-folinic acid 100 mg/m2 days 1-2, followed by 5-fluorouracil 400 mg/m2 bolus days 1-2, and then 600 mg/m2 as a 22-hour continuous infusion days 1-2, every 14 days, plus pegfilgrastim 6 mg on day 3. Sixty patients (50%) aged ≥65 years received the same schedule with a dose reduction by 30%.
  
  
  RESULTS
  A total of 86% of patients were evaluable for response and all for toxicity. In patients aged ≥65 years, we observed an overall response rate of 51%. Median overall survival was 11.2 (95% confidence interval [CI] 7.3-15.1) and 11.8 months (95% CI 9.2-16.2) in elderly and younger patients, respectively. In the elderly patients, the most frequent grade 3-4 toxicities were neutropenia (13%), leukopenia (7%), thrombocytopenia (18%), anemia (3%), and febrile neutropenia (8%); in the younger patients, neutropenia (56%), leucopenia (31%), thrombocytopenia (22%), anemia (15%), and febrile neutropenia (15%).
  
  
  CONCLUSIONS
  Elderly patients can be safely treated with a dose-dense TCF regimen with a 30% dose reduction achieving similar efficacy results as younger patients with lesser toxicity.
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Wanda
authors.initials: W
authors.lastname: Liguigli
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Tomasello
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Toppo
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Rossana
authors.initials: R
authors.lastname: Poli
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Lazzarelli
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Negri
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Perrucci
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Curti
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Brighenti
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Gianvito
authors.initials: G
authors.lastname: Donati
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Morena
authors.initials: M
authors.lastname: Nazzari
authors.affiliation:  General Surgery Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Martinotti
authors.affiliation:  General Surgery Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Vismarra
authors.affiliation:  General Surgery Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Rovatti
authors.affiliation:  Medical Oncology Division, Azienda Istituti Ospitalieri di Cremona, Cremona - Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Passalacqua
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology