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Outcomes in elderly patients treated with a single-agent or combination regimen as first-line chemotherapy for recurrent or metastatic gastric cancer

Gastric Cancer, 2015, Vol.18(3), pp.644-652 [Peer Reviewed Journal]

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  • Title:
    Outcomes in elderly patients treated with a single-agent or combination regimen as first-line chemotherapy for recurrent or metastatic gastric cancer
  • Author: Sun, Der ; Jeon, Eun ; Won, Hye ; Park, Ji ; Shim, Byoung ; Park, Suk ; Hong, Young ; Kim, Hoon ; Ko, Yoon
  • Found In: Gastric Cancer, 2015, Vol.18(3), pp.644-652 [Peer Reviewed Journal]
  • Subjects: First-line chemotherapy ; Gastric cancer ; Old age ; Palliative chemotherapy ; Metastasis ; Cancer recurrence
  • Language: English
  • Description: Byline: Der Sheng Sun (1), Eun Kyoung Jeon (2), Hye Sung Won (1), Ji Chan Park (3), Byoung Young Shim (4), Suk Young Park (3), Young Seon Hong (2), Hoon Kyo Kim (4), Yoon Ho Ko (1) Keywords: First-line chemotherapy; Gastric cancer; Old age; Palliative chemotherapy; Metastasis; Cancer recurrence Abstract: Background Palliative chemotherapy is used to prolong survival among elderly patients with inoperable gastric cancer (GC). We analyzed differences between single and combination first-line palliative chemotherapy among these patients. Methods Included patients were >70 years old and were treated for GC at four clinical centers of the Catholic University of Korea. Baseline characteristics, the first-line chemotherapy regimen, treatment responses, toxicities, progression-free survival (PFS), and overall survival (OS) were evaluated. Results Between 2005 and 2012, 178 > 70-year-old patients with GC received palliative chemotherapy using single or combination regimens. Median ages were 77 years (range 71--89) in the single regimen group (SG, 70 patients) and 73 years (range 71--81) in the combination group (CG, 108 patients). Patients in the SG received S-1 or capecitabine. The most common regimen in the CG was platinum combined with fluorouracil. The most common response in both groups was stable disease (SG, 45.7 % CG, 48.1 %). In the SG and CG, median PFS times were 4.4 months (95 % confidence interval [CI] 2.85--5.95) and 4.1 months (95 % CI 2.62--5.57 P = 0.295), respectively median OS times were 6.6 months (95 % CI 4.17--9.08) and 7.6 months (95 % CI 5.50--9.69 P = 0.782), respectively. Hematologic (P < 0.001) and non-hematologic toxicities (P < 0.001) were more frequent in the CG. The most common causes of chemotherapy cessation were disease progression in the SG and decreased performance status in the CG. Conclusions Single-agent treatment should be considered a first-line palliative chemotherapy option for elderly patients with GC. Author Affiliation: (1) Division of Oncology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea (2) Division of Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea (3) Division of Oncology, Department of Internal Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Soeul, 137-701, Republic of Korea (4) Division of Oncology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea Article History: Registration Date: 16/07/2014 Received Date: 24/03/2014 Accepted Date: 13/07/2014 Online Date: 07/08/2014
  • Identifier: ISSN: 1436-3291 ; E-ISSN: 1436-3305 ; DOI: 10.1007/s10120-014-0405-8

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