Chemotherapy in Elderly Patients with Metastatic Colorectal Cancer: Relations to Co-Morbidities and Functional Abilities

Purpose: We aimed to study the management of a cohort of elderly patients ( !65 years old) with metastatic colorectal cancer (mCRC) treated by our oncology team between April 2010 until December 2012 in relation to their co-morbidities and functional abilities. Methods: This was an observational prospective study. Results: Thirteen patients were treated with XELOX (oxaliplatin and capecitabine) regimen. They had Cumulative Illness Rating Scale for Geriatric (CIRS-G) score of 0-3, Lawton Instrumental Activity of Daily Living (IADL) score of 8 and performance status (PS) of 1. Partial response (PR) of 61.5% and stable (SD) 30.8% were achieved. The median progression free survival (PFS) and overall survival (OS) durations were 10 and 16 months respectively. Ten patients had oral capecitabine. They had CIRS-G score of 0-3, IADL score of 4-8 and PS 2. Two had PR (20%) and 6 SD (60%). The median PFS and OS were 11 and 12 months respectively. Five patients were treated with FOLFIRI (Irinotecan and modified Degramont) regimen. They had CIRS-G 1-3, Lawton IADL of 5-8 and PS 1-2. Two patients had PR (40%) and 1 (20%) SD. Median PFS and OS were 9 months and 14 months respectively. Fifteen patients had ischemic heart diseases were treated with Raltitrexed. They had CIRS-G score of 2-3, IADL score of 4-8 and PS 1-2. PR and SD rates were 35.7% each. Median PFS and OS were 7 and 10 months respectively. Conclusion: CIRS-G score, IADL and PS are quite helpful tools in assessing elderly patients prior to chemotherapy.