Chemotherapy in elderly patients with metastatic gastric cancer; a single Turkish cancer center experience

Abstract

Aim To analyze the results of chemotherapy applied at the Bülent Ecevit University School of Medicine, Department of Medical Oncology, to elderly patients with metastatic gastric cancer (GC). Methods The study retrospectively investigated hospital records including pathological reports, imaging records, chemotherapy regimens, response and toxicity profile. All patients received systemic chemotherapy for pathologically proven metastatic GC at the Bülent Ecevit University School of Medicine, Department of Medical Oncology. Results From 2005 to 2012, 23 metastatic GC patients older than 70 years were treated with systemic chemotherapy as a first-line therapy. As the first-line chemotherapy, 17 (74%) patients received polychemotherapy and the remaining six (26%) patients received monotherapy. Overall, 113 cycles were administered. The median progression free survival (PFS) for the first-line chemotherapy was 6 months (95% CI, 0-16) and the median overall survival (OS) was 14 months (95% CI, 3-30). Multivariate analysis revealed that decreased OS was significantly associated with poor Eastern Cooperative Oncology Group (ECOG) performance status (p=0.045), elevated carcinoembryonic antigen (CEA) levels at the diagnosis time (p = 0.040) and decreased number of chemotherapy cycles (p=0.019) with R-Sq (adj) = 41, 6%. One patient had a complete response with docetaxel, cisplatin and fluorouracil combined (DCF) regimen and had 12 months of disease free survival (DFS). Conclusion This is the first study investigating the outcomes of chemotherapy in Turkish elderly metastatic GC patients. Docetaxel, cisplatin and fluorouracil combination were the most common regimen, which is a tolerable and effective choice in elderly patients who had good performance status.