Abstract
Introduction: Colorectal Cancer (CRC) is the third leading cancer in the world, the prevalence of which increases with age. Although the treatment principles for metastatic CRC are similar in elderly and younger patients, chemotherapy toxicity requires consideration because of age-related physiological and functional changes and comorbidities. Thus, a combination of chemotherapy and biological drugs is recommended for the treatment of healthy elderly patients, as in younger patients. While young patients are more suitable for multiline treatment, older patients are typically under-treated. We aimed to elucidate whether multiline chemotherapy prolongs survival in patients aged ≥ 70 years with an Eastern Cooperative Oncology Group (ECOG) performance score of 0 or 1 by maintaining treatment as long as tolerated and to investigate treatment approaches in elderly patients by assessing factors that affect survival. Materials and Methods: We retrospectively evaluated the medical records of 136 patients (age ≥ 70 years) who presented to our clinic between May 2009 and January 2018. We assessed the OS using the Kaplan–Meier method and evaluated the difference in the survival time between the groups using the log-rank method. Results: The median OS was 13.1 months for patients receiving one to two line(s) of chemotherapy and 34.1 months for those receiving >2 lines of chemotherapy; the difference was statistically significant (P=0.001). Conclusion: This study suggests maintaining palliative systemic therapy in patients with an ECOG performance status score of 0 or 1, as it exhibits a significant difference in survival rates.
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