Article

Oxaliplatin- or irinotecan-based chemotherapy for metastatic colorectal cancer in the elderly.

Service d'Hépato-Gastroentérologie, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, AP-HP, Paris 75018, France.
British Journal of Cancer (Impact Factor: 5.08). 11/2003; 89(8):1439-44. DOI: 10.1038/sj.bjc.6601310
Source: PubMed

ABSTRACT The tolerance and efficacy of oxaliplatin and irinotecan for metastatic colorectal cancer are unknown in elderly patients. Methods. All consecutive patients over 74 years treated with oxaliplatin or irinotecan for metastatic colorectal cancer were enrolled. The tumour response was assessed every 2-3 months and toxicity was collected at each cycle according to World Health Organisation criteria. A total of 66 patients were enrolled from 12 centres. The median age was 78 years (range, 75-88 years); 39 patients had no severe comorbidity according to the Charlson score. In total, 44 and 22 patients received oxaliplatin or irinotecan, respectively, in combination with 5-fluororuracil+/-folinic acid or raltitrexed in 64 patients. A total of 545 chemotherapy cycles were administered in first (41%), second (51%) or third line (8%). A dose reduction occurred in 190 cycles (35%). Complete response, partial response and stabilisation occurred in 1.5, 20 and 47% of patients, respectively. The median time to progression and overall survival were 6.8 and 11.2 months in first line and 6.3 and 11.6 months in second line, respectively. Grade 3 and 4 toxicity occurred in 42% of patients: neutropenia 17%, diarrhoea 15%, neuropathy 11%, nausea and vomiting 8% and thrombopenia 6%. There was no treatment-related death. In selected elderly patients, chemotherapy with oxaliplatin or irinotecan is feasible with manageable toxicity.

0 Bookmarks
 · 
114 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: XELOX is a 3-weekly chemotherapy combination of oral capecitabine and intravenous oxaliplatin. The central hypothesis that led to its development was that it would provide a convenient and cost-effective alternative to intravenous fluorouracil-based chemotherapy doublets, without compromising on anti-tumor efficacy. Recently its role in colorectal cancer has become more established in both the metastatic and adjuvant setting. Ongoing investigation of XELOX continues in a number of directions: its combination with novel biological agents, its efficacy and safety in the elderly, and the development of biomarkers that can predict its anti-tumor effect. This article provides a comprehensive and up-to-date synopsis of all pertinent clinical studies detailing this regimen and its promise for the future.
    Expert review of gastroenterology & hepatology 02/2011; 5(1):9-19.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine the feasibility of using x-ray technology for internal defect removal, a discrete-event simulation model was developed with the capability to vary inspection machine configuration and placement and associated economic impact. To evaluate the profitability of X-ray inspection, the results of the simulation model were also used to estimate the unit cost (UC) and selling price per box of the inspected onions. A fundamental assumption of this work is that the increase in quality resulting from the X-ray inspection would command a higher market value as reflected by sales price. An Arena simulation model was developed based on data from two packinghouse time studies, from 2005 to 2006 onion X-ray inspection and sample measurements (4 cultivars each year) and from published cost estimates of sweet onion production and packing. The model results indicated the feasibility of incorporating three and four X-ray inspection units at 0.25 m s−1 belt speed under the simulated conditions to obtain realistic throughput rates. Estimated costs per 18.14 kg box of X-ray inspected onions ranged from US $9.00 to US $15.00 while the estimated selling price ranged from US $11.35 to US $25.34, depending on farm yield, the quality of incoming crop and the gross profit margin goals. The methods could be readily extended to other commodities destined for the fresh market; however, the results would be commodity and site specific.
    Biosystems Engineering. 01/2010;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To assess feasibility, tolerability and efficacy of gemcitabine-based chemotherapy in patients ≥ 75 years old with advanced pancreatic cancer. All consecutive patients ≥ 75 years old with advanced pancreatic adenocarcinoma were included in this retrospective study. Necessary criteria to receive chemotherapy were: performance status 0-2, adequate biological parameters and no serious comorbidities. Other patients received best supportive care (BSC). Thirty-eight patients (53% women, median age 78 years, range 75-84) with pancreatic cancer (metastatic: n = 20, locally advanced: n = 18) were studied. Among them, 30 (79%) were able to receive chemotherapy [median number: 9 infusions (1-45)]. Six patients (23%) had at least one episode of grade 3 neutropenia and one patient developed a grade 3 hemolytic-uremic syndrome. No toxic death occurred. Three patients (11%) had a partial tumor response, 13 (46%) had a stable disease and 12 (43%) had a tumor progression. Median survival was 9.1 mo (metastatic: 6.9 mo, locally advanced: 11.4 mo). Tolerance and efficacy of gemcitabine-based chemotherapy is acceptable in elderly patients in good condition, with similar results to younger patients.
    World Journal of Gastroenterology 08/2011; 17(30):3497-502. · 2.55 Impact Factor

Full-text (2 Sources)

View
41 Downloads
Available from
May 27, 2014