Elderly patients with advanced colorectal cancer: Tolerability and activity of chemotherapy

Aims and background: Colorectal cancer is the most common gastrointestinal tumor in Western countries and is increasing in elderly patients. In recent years, new treatments based on the use of 5-fluorouracil associated with oxaliplatin or CPT-11 have shown promising activity. The aim of the present study was to analyze the tolerability and activity of chemotherapy with 5-fluorouracil plus oxaliplatin or CPT-11 in elderly patients with advanced colorectal cancer. Methods: Patients aged 70 years or older with advanced colorectal cancer were treated with 5-fluorouracil (400 mg/m(2) in bolus and 600 mg/m(2) in a 22-hr continuous infusion on days 1-2) folinic acid (100 mg/m(2)) associated to oxaliplatin (85 mg/m(2) (180 mg/m(2) g/m(2) on day 1, FOLFOX regimen) or CPT-11 on day 1, FOLFIRI regimen), every 14 days. Results: Twenty-nine patients with a median age of 76 years (range, 70-82) were treated with FOLFOX or FOLFIRI as first-line chemotherapy for metastatic disease. We observed a partial response in 8/29 (27.6%), stable disease in 11129 (37.9%) and progressive disease in 10/29 (34.5%). Median survival was 21 months; 1-year survival probability was 89.8%. Grade III leukopenia was observed in 2/29 (7%) patients and grade III diarrhea in 1/29 patients. No other grade III-IV toxicity was observed. Conclusions: FOLFOX and FOLFIRI appear to be active and well tolerated regimens for elderly patients with advanced colorectal cancer.