Chemotherapy Helps Elderly Colon Cancer Patients

by on Aug.03, 2011, under Prescription Drug

Elderly patients who have undergone surgery for colon cancer can benefit from postoperative chemotherapy, researchers have found.

While younger colon cancer patients are offered postoperative or adjuvant chemotherapy as a matter of course, patients older than 70 are less likely to receive the potentially life-prolonging drugs because they are believed to be more vulnerable to their toxic side effects.

But according to an analysis of seven trials published in the October 11th issue of The New England Journal of Medicine, some older patients tolerate chemotherapy as well as younger patients and benefit equally.

“Selected elderly patients with colon cancer can receive the same benefit from…(postoperative chemotherapy) as their younger counterparts, without a significant increase in toxic effects,” Dr. Daniel J. Sargent from the Mayo Clinic in Rochester, Minnesota, and colleagues report.

The researchers analyzed studies that included more than 3,300 colon cancer patients ranging from younger than 50 years to older than 70. They compared side effects–which included nausea, vomiting and an abnormally low white blood cell count or leukopenia–among patients on two different chemotherapy regimens and those who did not take any generic drugs after their surgery.

Chemotherapy prolonged survival in all age groups. After 5 years, 71% of those who received postoperative chemotherapy were still alive, compared with 64% of those who did not take drugs. Additionally, cancer was less likely to return within 5 years of surgery among patients who took chemotherapy.

“No significant interaction was observed between age and the efficacy of treatment,” Sargent and colleagues note, and there were no major differences in rates of side effects among age groups. But one study did find that patients older than 70 were more likely to develop leukopenia.

The findings have broader implications for the treatment of colon cancer, as people 65 years or older account for up to three quarters of colorectal cancers in the US, Dr. Hyman B. Muss of the University of Vermont in Burlington writes in an editorial. He points out that by 2030, roughly 20% of the US population will be at least 65 years old, compared with about 13% of the population today.

“Age alone should not be used to deny potentially beneficial treatment to any patient with cancer,” Muss concludes.

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