Triple Combination Chemotherapy in Elderly Metastatic Gastric Cancer Patients

Abstract

This study was conducted in order to evaluate the response rate, progression free survival (PFS), overall survival (OS), safety and prognostic factors of weekly S-1, paclitaxel plus cisplatin chemotherapy in patients older than 65 years. We administered the triple regimen to patients older than 65 years with recurrent or metastatic gastric cancer. The response rate, PFS, safety of triple combination chemotherapy was evaluated. Clinical outcomes of the elderly group (≥65 years old; n = 28) were compared with those of the non-elderly group (<65 years old; n = 68). The common metastatic lesions were abdominal lymph nodes (57.1%). The median number of cycle was 3.3 cycles (range; 1~9). The disease response rate was 50.0%. The median PFS was 6.2±0.46 months and median OS was 7.6±1.46 months. This treatment was moderately tolerated with grade 3/4 neutropenia in 67.9%, grade 3 anemia in 21.4%. Non-hematologic toxicities were grade 3 general weakness in 25.0% of patients. Compare to younger patients, more grade 3/4 neutropenia, anemia and general weakness were observed. Treatment related mortality was 3.6%. Only body mass index (BMI) was correlated with overall survival by cox regression analysis (p = 0.043). Triple regimen in elderly gastric cancer patients showed relatively high disease response rate and survival duration similar to younger patients, but more frequent neutropenia, anemia and general weakness were seen as barriers to treatment in elderly patients. Especially in low BMI elderly patients, triple regimen chemotherapy must be used with caution.