Abstract
The authors have retrospectively analyzed the tolerability and efficacy of oxaliplatin plus bolus 5-fluorouracil and leucovorin in patients with metastatic colorectal cancer according to their age: under 65 years (n = 78) and 65 years or older (n = 61). Baseline characteristics were similar in the two groups. Oxaliplatin intravenous 100 mg/m2 on day 1, l-leucovorin 250 mg/m2 and intravenous 5-fluorouracil 1050 mg/m2 on day 2; or oxaliplatin 85 mg/m2, l-leucovorin 250 mg/m2 and 5-fluorouracil 850 mg/m2 were given every 2 weeks in younger (40 and 38) and elderly (31 and 30) patients, respectively. The median number of cycles and median duration of treatment were similar in the younger and elderly group. With the first regime, grade 3 or greater toxicity of any type (60 vs 58%) and febrile neutropenia (12 vs 13%) affected younger and elderly patients similarly, but severe diarrhea occurred more frequently among elderly patients (12 vs 19%). With the second, lower-dose regime, no difference was observed in the frequency of febrile neutropenia (0 vs 3%) or severe diarrhea (10 vs 13%) among younger and elderly patients. Complete (17 vs 11%) and overall (47 vs 39%) response rates were insignificantly higher in younger patients, while progression-free survival (8.1 vs 8.4 months) and overall survival (18.6 vs 19.4 months) were comparable. Therefore, the low-dose regimen represents a new treatment option, and also deserves further evaluation in elderly patients.