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Folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy

AIM: To study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer. METHODS: This retrospective study included elderly patients aged over 70 years of age treated at Georges-Francois Leclerc Center by FOLFIRINOX for histological proved colo...

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Autores principales: Guion-Dusserre, Jean-Florian, Bertaut, Aurélie, Ghiringhelli, François, Vincent, Julie, Quipourt, Valérie, Marilier, Sophie, Tharin, Zoé, Bengrine-Lefevre, Leila
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107701/
https://www.ncbi.nlm.nih.gov/pubmed/27895425
http://dx.doi.org/10.3748/wjg.v22.i42.9378
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author Guion-Dusserre, Jean-Florian
Bertaut, Aurélie
Ghiringhelli, François
Vincent, Julie
Quipourt, Valérie
Marilier, Sophie
Tharin, Zoé
Bengrine-Lefevre, Leila
author_facet Guion-Dusserre, Jean-Florian
Bertaut, Aurélie
Ghiringhelli, François
Vincent, Julie
Quipourt, Valérie
Marilier, Sophie
Tharin, Zoé
Bengrine-Lefevre, Leila
author_sort Guion-Dusserre, Jean-Florian
collection PubMed
description AIM: To study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer. METHODS: This retrospective study included elderly patients aged over 70 years of age treated at Georges-Francois Leclerc Center by FOLFIRINOX for histological proved colorectal or pancreatic cancer between January 2009 and January 2015. Chemotheapy regimen consisted of oxaliplatin (85 mg/m(2) in over 120 min) followed by leucovorin (400 mg/m(2) in over 120 min), with the addition, after 30 min of irinotecan (180 mg/m(2) in over 90 min) then 5 fluorouracil (5FU) (400 mg/m(2) administred intravenous bolus), followed by 5FU (2400 mg/m(2) intraveinous infusion over 46 h) repeated every 2 wk. Geriatric parameters were recorded at the beginning. Toxicities were evaluated with the Common Terminology Criteria for Adverse Events 4.03. Tumor response was evaluated by CT scan. Treatment continued until disease progression, unacceptable toxicities or patient refusal. RESULTS: Fifty-two patients aged from 70 to 87 years were treated by FOLFIRINOX, 34 had colorectal cancer and 18 had pancreatic cancer. Most of them were in good general condition, 82.7% had a 0-1 performance status and 61.5% had a Charlson Comorbidity Index < 10. The most frequent severe toxicities were neutropenia (17 patients, n = 32.7%) and diarrhea (35 patients n = 67.3%); 10 of the case of neutropenia and 5 of diarrhea registered a grade 4 toxicity. Thirty-nine patients (75%) initially received an adapted dose of chemotherapy. The dosage was adjusted for 26% of patients during the course of treatment. Tumor response evaluated by RECIST criteria showed a controlled disease for 25 patients (48.1%), a stable disease for 13 and a partial response for 12 patients. Time under treatment was higher for colorectal cancer with a median time of 2.44 mo (95%CI: 1.61-3.25). Overall survival was 43.88 mo for colorectal cancer and 12.51 mo for pancreatic cancer. In univariate or multivariate analysis, none of geriatric parameters were linked to overall survival. Only the type of tumor (pancreatic/colorectal) was linked in both analysis. CONCLUSION: For people over 70 years old, FOLFIRINOX regimen seems to induce manageable toxicities but similar, even higher, median survival rates compared to younger people.
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spelling pubmed-51077012016-11-28 Folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy Guion-Dusserre, Jean-Florian Bertaut, Aurélie Ghiringhelli, François Vincent, Julie Quipourt, Valérie Marilier, Sophie Tharin, Zoé Bengrine-Lefevre, Leila World J Gastroenterol Retrospective Study AIM: To study the tolerance and the efficiency of FOLFIRINOX in elderly patients diagnosed with colorectal or pancreatic cancer. METHODS: This retrospective study included elderly patients aged over 70 years of age treated at Georges-Francois Leclerc Center by FOLFIRINOX for histological proved colorectal or pancreatic cancer between January 2009 and January 2015. Chemotheapy regimen consisted of oxaliplatin (85 mg/m(2) in over 120 min) followed by leucovorin (400 mg/m(2) in over 120 min), with the addition, after 30 min of irinotecan (180 mg/m(2) in over 90 min) then 5 fluorouracil (5FU) (400 mg/m(2) administred intravenous bolus), followed by 5FU (2400 mg/m(2) intraveinous infusion over 46 h) repeated every 2 wk. Geriatric parameters were recorded at the beginning. Toxicities were evaluated with the Common Terminology Criteria for Adverse Events 4.03. Tumor response was evaluated by CT scan. Treatment continued until disease progression, unacceptable toxicities or patient refusal. RESULTS: Fifty-two patients aged from 70 to 87 years were treated by FOLFIRINOX, 34 had colorectal cancer and 18 had pancreatic cancer. Most of them were in good general condition, 82.7% had a 0-1 performance status and 61.5% had a Charlson Comorbidity Index < 10. The most frequent severe toxicities were neutropenia (17 patients, n = 32.7%) and diarrhea (35 patients n = 67.3%); 10 of the case of neutropenia and 5 of diarrhea registered a grade 4 toxicity. Thirty-nine patients (75%) initially received an adapted dose of chemotherapy. The dosage was adjusted for 26% of patients during the course of treatment. Tumor response evaluated by RECIST criteria showed a controlled disease for 25 patients (48.1%), a stable disease for 13 and a partial response for 12 patients. Time under treatment was higher for colorectal cancer with a median time of 2.44 mo (95%CI: 1.61-3.25). Overall survival was 43.88 mo for colorectal cancer and 12.51 mo for pancreatic cancer. In univariate or multivariate analysis, none of geriatric parameters were linked to overall survival. Only the type of tumor (pancreatic/colorectal) was linked in both analysis. CONCLUSION: For people over 70 years old, FOLFIRINOX regimen seems to induce manageable toxicities but similar, even higher, median survival rates compared to younger people. Baishideng Publishing Group Inc 2016-11-14 2016-11-14 /pmc/articles/PMC5107701/ /pubmed/27895425 http://dx.doi.org/10.3748/wjg.v22.i42.9378 Text en ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Retrospective Study
Guion-Dusserre, Jean-Florian
Bertaut, Aurélie
Ghiringhelli, François
Vincent, Julie
Quipourt, Valérie
Marilier, Sophie
Tharin, Zoé
Bengrine-Lefevre, Leila
Folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy
title Folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy
title_full Folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy
title_fullStr Folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy
title_full_unstemmed Folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy
title_short Folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy
title_sort folfirinox in elderly patients with pancreatic or colorectal cancer-tolerance and efficacy
topic Retrospective Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107701/
https://www.ncbi.nlm.nih.gov/pubmed/27895425
http://dx.doi.org/10.3748/wjg.v22.i42.9378
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