Older Patients with Colon Cancer: Is Adjuvant Chemotherapy Safe and Effective?

Autor: Arora, Amit, Potter, Jane, Sargent, DJ, Goldberg, RM, Jacobson, SD
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Zdroj: Journal of the American Geriatrics Society; Apr2003, Vol. 51 Issue 4, p567-569, 3p
Abstrakt: PURPOSE: To investigate the efficacy and toxicity of fluorouracil-based adjuvant chemotherapy in patients aged 70 years and older with resected Stage II or III colon cancer who are at high risk for recurrence. BACKGROUND: Colorectal cancer accounts for 15% of all cancers in men and women and, after lung cancer, is the second-leading cause of cancer overall and the first in women aged 75 and older. 1 Older patients with cancer do not receive what is considered to be standard chemotherapy and are treated less often than younger patients regardless of the disease site or stage at diagnosis. 2,3 Adjuvant chemotherapy for colon cancer reduces the risk of death significantly, compared with surgery alone. 4,5 Currently, fluorouracil plus leucovorin for 6 to 8 months is standard adjuvant treatment for node-positive Stage III colon cancer. 6,7 The benefits of fluorouracil-based therapy for Stage II colon cancer are unclear. For all patients with colon carcinoma in the National Cancer Data Base, the use of surgery plus chemotherapy declined with age; 40% of patients younger than 50 received both treatments, compared with 20% of patients aged 70 to 79. There is now accumulating evidence suggesting that selected older patients can receive the same benefit as their younger counterparts, without a significant increase in toxic effects. A careful appraisal of the treatment of older patients with adjuvant chemotherapy for colon cancer is presented. DATA SOURCES: All reported studies (except three trials that have not yet completed follow-up and one trial unavailable because of computer malfunction) comparing postoperative fluorouracil plus leucovorin or fluorouracil plus levamisole with surgery alone were identified using a Medline search, a search of bibliographies, and discussion with the leaders of each identified trial. STUDY SELECTION CRITERIA: Seven studies that met the following criteria were included in this pooled analysis:... [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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