Seniors on Adjuvant Chemo Have Less Toxic Regimens

Older colon cancer patients on chemo also have fewer adverse events than younger patients
By Jeff Muise
HealthDay Reporter

TUESDAY, March 16 (HealthDay News) -- Older patients with colon cancer who receive adjuvant chemotherapy tend to have less-toxic and shorter chemotherapy regimens and suffer fewer adverse events than younger patients, according to a study in the March 17 issue of the Journal of the American Medical Association.

Katherine L. Kahn, M.D., of RAND Corporation in Santa Monica, Calif., and colleagues analyzed data on 675 patients with stage III colon cancer, who had undergone surgery and received adjuvant chemotherapy. The patients were stratified by age and followed for up to 15 months for adverse events and their relationship to their chemotherapy regimen, dose and duration of treatment.

The researchers found that 50 percent of the patients 75 years or older underwent adjuvant chemotherapy compared to 87 percent of the patients under 75 years. For those receiving chemotherapy, only 14 percent of the patients 75 or older received an oxaliplatin regimen, which has been shown to be more effective but more toxic than standard chemotherapy regimens, while 44 percent of the patients under 75 received oxaliplatin. By 150 days, 40 percent of patients 65 years or older had stopped treatment compared to 25 percent of patients under 65 years. Overall, the adjusted rate of late adverse events was lower for patients 75 years and older (mean, 0.28) than for younger patients (0.35 for ages 18 to 54 years, 0.52 for 55 to 64 years, and 0.45 for 65 to 74 years).

"Our findings underscore that practical clinical trials of adjuvant chemotherapy for older patients with stage III colon cancer are needed, including patients with comorbidities and functional impairment. Such trials should include patients across diverse community practice settings regardless of whether they have comorbidity," the authors write.

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