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Annals of Oncology 12:435-442, 2001
© 2001 European Society for Medical Oncology

review-article

Chemotherapy in elderly patients with colorectal cancer

C.-H. Köhne1,, A. Grothey2, C. Bokemeyer3, N. Bontke1 and M. Aapro4

1Departments of Hematology/Oncology, University Rostock Germany
2Departments of Hematology/Oncology, University Halle Germany
3Departments of Hematology/Oncology, University Tübingen Germany
4Departments of Hematology/Oncology, Institute Multidisciplinaire d'Oncologie, Clinique de Genolier Genolier, Switzerland

Correspondence to: PD Dr med C -H Köhne, University of Rostock, Clinic of Internal Medicine, Department of Hematology/Oncology, Ernst-Heydemann-Strasse 6, 18057 Rostock, Germany, E-mail henning.koehne{at}med.uni-rostock.de

Background Colorectal cancer is usually diagnosed in patients around 70 years of age With a continuous increase in life expectancy we may expect a higher number of elderly patients in the future Because patients above 70 or 75 years are often excluded there is uncertainty as to what extent systemic adjuvant and palliative treatment should be offered to elderly patients.

Methods We reviewed the available literature on adjuvant and metastatic colorectal cancer in order to identify reports on elderly patients treated within chemotherapy trials

Results Only about 20% of patients entering clinical trials belong to the age group of over 70 years and represent the minority of the very fit patients Compared to their younger counterparts 5-FU-based treatment appears to be equally effective and more toxic according to some reports Data regarding raltitrexed, oral fluoropyrimidines, topoisomerase I inhibitors or DACH-platin derivates are limited but suggest no age-specific differences in activity or toxicity.

Conclusions Elderly patients should not be excluded from clinical trials and studies in unfit elderly patients are warranted Elderly patients need more attention regarding their functional, social and mental status Fit elderly patients should be offered adjuvant or palliative chemotherapy

colorectal cancer chemotherapy elderly review


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