• Jpn. J. Clin. Oncol. · Feb 2013

    Comparative Study

    Practical outcome of adjuvant FOLFOX4 chemotherapy in elderly patients with stage III colon cancer: single-center study in Korea.

    • Ji-Yeon Kim, Yu Jung Kim, Keun-Wook Lee, Jong Seok Lee, Duck-Woo Kim, Sung-Bum Kang, Hye Seung Lee, Na Young Jang, Jae-Sung Kim, and Jee Hyun Kim.
    • Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 beon-gil, Bundang-gu, Seongnam 463-707, Korea. jhkimmd@snubh.org
    • Jpn. J. Clin. Oncol. 2013 Feb 1; 43 (2): 132-8.

    ObjectiveElderly patients derive similar benefits from 5-fluorouracil-based adjuvant chemotherapy in Stage III colon cancer; however, conflicting data exist regarding additional benefit from oxaliplatin, fluorouracil and leucovorin (FOLFOX) chemotherapy.MethodsSingle-center, retrospective analysis was performed to compare the safety and efficacy of adjuvant oxaliplatin, fluorouracil and leucovorin-4 chemotherapy in older patients (age ≥65 years) with younger patients with Stage III colon cancer after surgical resection.ResultsAmong 391 patients with Stage III colon cancer, 229 patients received adjuvant oxaliplatin, fluorouracil and leucovorin chemotherapy (87 (43.5%) ≥65 years old versus 142 (74.3%) <65 years old). Older patients had similar clinico-pathological characteristics as younger patients except for higher Charlson-Age comorbidity score (median 3.44 versus 2.85, P < 0.01). The estimated 3-year disease-free survival (76.5 versus 80.0%, P = 0.88) and 3-year overall survival (90.9 versus 92.7%, P = 0.98) were similar. Grade 3-4 neutropenia was the only toxicity with higher frequency in the elderly patients (62.1 versus 46.5%, P = 0.02). Elderly patients received a lower relative dose intensity of oxaliplatin (0.76 versus 0.79) and 5-fluorouracil (0.75 versus 0.80, P = 0.009).ConclusionsAdjuvant oxaliplatin, fluorouracil and leucovorin chemotherapy resulted in similar efficacy without significant increase in toxicity in older patients aged ≥65 when compared with younger patients with curatively resected Stage III colon cancer. Therefore, for colon cancer patients aged ≥65, oxaliplatin, fluorouracil and leucovorin chemotherapy can be recommended as safe and effective adjuvant chemotherapy after curative surgery in Asia.

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