2004 Volume 50 Issue 1 Pages 84-91
Objective : This study was performed to investigate whether chemotherapy is effective for unresectable advanced gastric cancer in elderly patients over 70 years old. Subjects and methods : The Subjects were 19 patients over 70 years old and 55 patients under 70 years old who received combination chemotherapy at our department over the past 12 years. The elderly group consisted of 15 males and 4 females with a mean age of 75.1 years, ranging from 70 to 79. The younger group consisted of 40 males and 15 females with a mean age of 55.0 years, ranging from 21 to 69. They were treated with a combination of 5-fluorouracil and cisplatin (CDDP) alone or with addition of mitomycinC (MMC), etoposide (VP16), leucovorin (LV) or irinotecan hydrochloride (CPT11), and evaluated for efficacy rate, median survival time (MST), average number of days residing at home, residing at home for over 50 % of their survival time, and improvement of P. S. Result : The systemic therapies for the elderly group of patients were effective in 4 out of 19 cases [21.1%, Complete Response (CR); 1, Partial Response (PR); 3, Minimal Response (MR); 5, No Change (NC); 9, Progressive Disease (PD); 1], while for the younger patients therapy was effective in 14 out of 55 cases [25.5 %, CR; 1, PR; 13, MR; 5, NC; 23, PD; 13]. The MST of the elderly group was 272.0 days, compared to 208.0 days for the younger group. The average number of days residing at home for the elderly group was 194.9 days, while for the younger group it was 136.2 days. Ten (52.6%) of the elderly patitnts resided at home for over 50 % of their survival time, and 19 (34.5%) did so in the younger group. Improvement of performance status (P.5) was found in 14 subjects (73.4%) in the elderly group, and 31 (56.3%) in the younger group. Observed side effects for the elderly group were leukopenia in 8 cases (42.1%), thrombocytopenia in 2 cases (10.5%), anemia in 1 case (5.3%) and nausea or vomiting in 0 cases (0%). For the younger group leukopenia was seen in 3 cases (5.5%, thrombocytopenia in 3 cases (5.5%), anemia in 1 case (1.9%), and nausea or vomiting in 5 cases (9.1%). They were all classified as grade 3 side effects. Conclusion : These result suggested that chemotherapy for the elderly group with unresectable advanced gastric cancer was more effective than for the younger group, because the improvement of quality of life (QOL) for the elderly group was recognized in comparison of the average number of days residing at home, residing at home for over 50 % of survival time, and improvement of P. S.
