Treatment of advanced oesophagogastric cancer with FOLFOX-4 regimen followed by leucovorin/bolus and continuous infusion 5-FU as maintenance chemotherapy in patients aged 鈮?75 years with impaired performance status

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• 作者：Roberto Petrioli^a ; ^{r.petrioli@ao-siena.toscana.it" class="auth_mail" title="E-mail the corresponding author} ; Edoardo Francini^b ; Franco Roviello^c ; Daniele Marrelli^d ; Salvatora Tindara Miano^a ; Anna Ida Fiaschi^e ; Letizia Laera^a ; Marco Antonio Bellini^f ; Giandomenico Roviello^a
• 关键词：Capecitabine ; Elderly ; FOLFOX ; Gastric cancer ; Performance status
• 刊名：Journal of Geriatric Oncology
• 出版年：2015
• 出版时间：September 2015
• 年：2015
• 卷：6
• 期：5
• 页码：380-386
• 全文大小：432 K

文摘

To evaluate the efficacy and safety of FOLFOX-4 combination chemotherapy, followed by leucovorin (LV)/bolus and continuous infusion 5-fluorouracil (5-FU) as maintenance chemotherapy in elderly (≥ 75 years) patients with advanced oesophagogastric cancer with impaired performance status (PS).

Materials and Methods

Patients with a PS score > 1 were included in this study. PS evaluations were performed by a geriatrician and two medical oncologists. FOLFOX-4 consisted of oxaliplatin concurrently with LV/bolus and continuous infusion 5-FU every 2 weeks. After a maximum of six FOLFOX-4 cycles, patients with no evidence of disease progression received maintenance treatment with LV/bolus and continuous infusion 5-FU every 2 weeks until disease progression or unacceptable toxicity.

Results

Thirty-eight patients were enrolled in this study. Of these, 32 (84.2%) patients had a PS score of 2 and six (15.7%) patients had a PS score of 3. After completion of FOLFOX-4, 18 (47.3%) patients achieved a partial response and 14 (36.8%) patients had stable disease. Thirty-two patients (84.2%) received maintenance chemotherapy for a median of eight cycles (range one to 26 cycles). The 6-month disease-control rate was 47.3% [95% confidence interval (CI) 30.9–64.1]. The median progression-free survival was 5.9 months (95% CI 4.7–6.8) and the median overall survival was 9.6 months (95% CI 8.1–11.7). Grade 3 neutropenia occurred in six patients (15.7%), and Grade 3 anaemia and thrombocytopenia occurred in two patients (5.2%).

Conclusion

FOLFOX-4 followed by LV/bolus and continuous infusion 5-FU as maintenance chemotherapy seems to be an active and well-tolerated first-line treatment strategy for elderly patients with advanced oesophagogastric cancer and impaired PS.