Abstract:

Introduction: Elderly patients are under-represented in the clinical trials of patients with metastatic gastric cancer (GC); therefore, the efficacy and tolerability of palliative chemotherapy are unclear in these patients. We aimed to assess the efficacy and tolerability of first-line palliative chemotherapy in elderly patients (age ≥70 years) with metastatic GC. Materials and Method: From 2005 to 2014, 89 patients with metastatic GC who were 70 years and older and were treated with at least two cycles of systemic chemotherapy as first-line treatment were included retrospectively. Disease and patient characteristics, prognostic factors, treatment response, grade 3–4 toxicity related to treatment, progression free survival (PFS), and overall survival (OS) were evaluated. Results: Of the 89 patients, 65 (73%) were males; median age was 74 (70–84) years. The median follow-up period was 7 months (min–max: 2–57 months), median PFS was 5 months (95% CI: 3.7–6.3), and median OS was 7 months (95 % CI: 5.2–8.9). The disease was controlled in 43.8% patients, whereas progression was observed in 56.2% patients. Univariate analysis showed that the Eastern Cooperative Oncology Group (ECOG) performance status, number of chemotherapy cycles, and response to the first line chemotherapy had a significant effect on PFS and OS; liver metastasis had an effect only on PFS; lung metastasis had an effect only on OS. Conclusion: Fewer chemotherapy cycles, lung metastasis, liver metastasis, and poor ECOG performance scores were found to be poor prognostic factors.

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