Older versus younger patients with metastatic adenocarcinoma of the esophagus, gastroesophageal junction, and stomach: A pooled analysis of eight consecutive North Central Cancer Treatment Group (NCCTG) trials

Aminah Jatoi, Nathan R. Foster, James R. Egner, Patrick A. Burch, Philip J. Stella, Joseph Rubin, Shaker R. Dakhil, Daniel J. Sargent, Brian R. Murphy, Steven Robert Alberts

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Whether elderly patients with metastatic esophageal, gastroesophageal, and gastric cancer do as well with chemotherapy as their younger counterparts was investigated in this pooled analysis. In total, 367 patients from 8 consecutive, first-line trials were included: i) etoposide + cisplatin; ii) 5-fluorourucil + leucovorin; iii) 5-fluorouracil + levamisole; iv) irinotecan; v) docetaxel + irinotecan; vi) oxaliplatin + capecitabine; vii) docetaxel + capecitabine; and viii) bortezomib + paclitaxel + carboplatin. One hundred and fifty-four (42%) patients were ≥65 years old (range: 65-86), and 213 younger (range: 20-64). Elderly patients had worse performance scores (2-3): 19 vs. 8% (p<0.0001). Rates of grade 3+ adverse events across all chemotherapy cycles in univariate and multivariate analyses (adjusted for gender, performance score, and stratified by individual study) were higher among elderly patients. Rates of neutropenia, fatigue, infection, and stomatitis in elderly vs. younger patients were 31 vs. 29% (p=0.02 by multivariate analyses); 15 vs. 5% (p=0.01); 9 vs. 4% (p=0.03); 6 vs. 1% (p=0.04). In contrast, duration of chemotherapy, overall survival, and progression-free survival were comparable. Although age should not preclude trial entry, these adverse event rates suggest a need to develop more tolerable regimens for older patients with these malignancies.

Original languageEnglish (US)
Pages (from-to)601-606
Number of pages6
JournalInternational Journal of Oncology
Volume36
Issue number3
DOIs
StatePublished - 2010

Fingerprint

Esophagogastric Junction
Stomach
irinotecan
docetaxel
Neoplasms
oxaliplatin
Drug Therapy
Therapeutics
Multivariate Analysis
Levamisole
Stomatitis
Leucovorin
Carboplatin
Etoposide
Esophageal Neoplasms
Paclitaxel
Adenocarcinoma Of Esophagus
Neutropenia
Fluorouracil
Cisplatin

Keywords

  • Adverse events
  • Chemotherapy
  • Elderly
  • Esophageal cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Older versus younger patients with metastatic adenocarcinoma of the esophagus, gastroesophageal junction, and stomach : A pooled analysis of eight consecutive North Central Cancer Treatment Group (NCCTG) trials. / Jatoi, Aminah; Foster, Nathan R.; Egner, James R.; Burch, Patrick A.; Stella, Philip J.; Rubin, Joseph; Dakhil, Shaker R.; Sargent, Daniel J.; Murphy, Brian R.; Alberts, Steven Robert.

In: International Journal of Oncology, Vol. 36, No. 3, 2010, p. 601-606.

Research output: Contribution to journalArticle

Jatoi, Aminah ; Foster, Nathan R. ; Egner, James R. ; Burch, Patrick A. ; Stella, Philip J. ; Rubin, Joseph ; Dakhil, Shaker R. ; Sargent, Daniel J. ; Murphy, Brian R. ; Alberts, Steven Robert. / Older versus younger patients with metastatic adenocarcinoma of the esophagus, gastroesophageal junction, and stomach : A pooled analysis of eight consecutive North Central Cancer Treatment Group (NCCTG) trials. In: International Journal of Oncology. 2010 ; Vol. 36, No. 3. pp. 601-606.
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