Purpose: Recent advances in the management of colorectal cancer have improved the quality of life and the survival of patients treated with chemotherapy. In order to define the contribution of chemotherapy in elderly patients, we studied the tolerance and the efficacy of first-line chemotherapy in patients with metastatic colorectal cancer.
Methods: Patients aged over 75 years received, as outpatient therapy, a bimonthly 48 h leucovorin and fluorouracil regimen. Evaluation was assessed every six cycles (i.e., three months).
Results: Fifty patients were studied: 28 males and 22 females, aged between 75 to 87 years, 37 with colon cancer and 13 with rectal cancer. Among 45 patients capable of being evaluated, the response rate was 44%, with six complete responses (13%) and 14 partial responses (31%). Eighteen patients had stable disease (40%) and seven patients progressive disease (16%). Median progression-free survival was 8.8 months and median survival 16.4 months. Grade 3 to 4 toxicity occurred in 20% of the patients. Performance status improved in 56% of the patients.
Conclusion: The bimonthly regimen is well tolerated in elderly patients and appears to prolong survival as well in younger patients.