Background Colorectal cancer represents a major health problem in developed countries. The incidence increases with age. Median age at diagnosis is about 70 years. This creates new needs in the treatment antineoplastic, considering the characteristics of this group of patients: functional alterations that increase the toxicity of drugs, high comorbidity and polypharmacy.
Purpose To describe chemotherapy treatments in elderly patients with colorectal cancer.
Material and methods Descriptive, retrospective study in which patients selected were older than 70 years who had received chemotherapy treatment for colorectal cancer, in the period January 2016 to October 2017. Data collected: sex, age, treatment schemes, reduction in dosage, duration of treatment and side effects.
Results Thirty-four patients were included, mean age 72.97±3.36, 58.82% men (n=20). Baseline ECOG was 0 in 29.42% of cases, 1 in 66.64% and 2 in 2.94%. 64.70% patients were diagnosed with stage-IV, 26.47% stage-III and 8.83% stage-II.
Twelve patients in stage II–III were treated with adjuvant-chemotherapy: XELOX (oxaliplatin/capecitabine), FOLFOX6 (oxaliplatin/fluorouracil/folinate) or capecitabine monotherapy. Six patients relapsed: median to relapse was 11 months (4–20).
Patients in stage-IV: 50% liver metastasis, 27.27% lung-liver metastasis, 9.1% retroperitoneum-liver, 9.1% lung metastasis and 4.53% retroperitoneum metastasis.
7/22 patients received perioperative-chemotherapy: XELOX or mFOLFOX6. Four patients relapsed, median to relapse: 5.5 months (3–11).
Twenty-five patients received palliative chemotherapy, median of overall survival 24, (95% CI: 21 to 27). Median of lines of treatments was 3 (1–6). Schemes utilised in first-line: FOLFOX±cetuximab or bevacizumab, FOLFIRI±cetuximab or bevacizumab (irinotecan/fluorouracil/folinate), XELOX, capecitabine.
Fifty per cent of patients underwent dose reduction and 60% had delays of administration due to toxicity.
Side effects: 56% suffered from asthaenia (grade 2–3), 28% mucositis (grade 1–3), 44% neutropaenia (grade 2–3), 60% diarrhoea (grade 2–3), 20% nausea grade 1, 16% vomit (grade 1–2), 56% cutaneous toxicity associated with anti-EGFR drug (grade 1–3), 24% thrombocytopaenia (grade 1–2), 20% neurotoxicity (grade 1–3) and 20% paraesthesia (grade 1–2).
Conclusion There is a tendency to reduce drug doses in the elderly patient, although not always in an established manner. It would be interesting to undertake studies to adapt the intravenous chemotherapy treatment differently to the rest of the adult population, as well as to objectify the overall health, quality of life and functionality of the elderly patient.
References and/or acknowledgements No conflict of interest.