Patients who receive surgery for stage III colon cancer can benefit from 5-flurouracil (5-FU)-based chemotherapy.
However, 5-FU-based chemotherapy is associated with increased risk of developing gastrointestinal, blood, and cardiac toxicities in elderly patients with colon cancer. These patients need to be monitored closely so that the benefits of chemotherapy can outweigh the risks, suggest the study authors.
In a study of 12,099 patients with stage III colon cancer, patients receiving chemotherapy were more likely to be younger, married, and have fewer coexisting conditions than the untreated group.
This difference was most pronounced for age, with 88.2% of patients aged 65-69 initiating chemotherapy compared to just 18.1% of patients aged 85 and older.
During 3 months after surgery, the cumulative incidence rate of toxicities was 9.1% in the chemotherapy group and 4.3% in the non-chemotherapy group.
Common toxicities included volume depletion disorder, agranulocytosis, diarrhea, nausea, and vomiting. Women were 35% more likely to experience toxicities than men and Blacks were 35% less likely to develop toxicities than Whites.
Chemotherapy was only slightly associated with the risk for developing heart disease.
For more info, see Hu, C-Y. et al. (2012). Adjuvant chemotherapy and risk of gastrointestinal, hematologic, and cardiac toxicities in elderly patients with stage III colon cancer. American Journal of Clinical Oncology, 35(3), 228-236.