To evaluate treatment-related toxicity, treatment compliance, surgical complications and event-free survival (EFS) in older (70 years) versus younger (<70 years) adults who underwent perioperative treatment for gastric cancer. Methods: In the CRITICS trial, 788 patients with resectable gastric cancer were randomised before start of any treatment and received preoperative chemotherapy (3 cycles of epirubicin, cisplatin or oxaliplatin and capecitabine), followed by surgery, followed by either postoperative chemotherapy or chemoradiotherapy (45Gy þ cisplatin þ capecitabine). Results: 172 (22%) patients were older adults. During preoperative chemotherapy, 131 (77%) older adults versus 380 (62%) younger adults experienced severe toxicity (p < 0.001); older adults received significantly lower relative dose intensities (RDIs) for all chemotherapeutic drugs. Equal proportions of older versus younger adults underwent curative surgery: 137 (80%) versus 499 (81%), with comparable postoperative complications and postoperative mortality. Postoperative therapy after curative surgery started in 87 (64%) older adults versus 391 (78%) younger adults (p < 0.001). Incidence of severe toxicity during postoperative chemotherapy was 22 (54%) in older adults versus 113 (59%) in younger adults (p Z 0.541); older adults received significantly lower RDIs for all chemotherapeutic drugs. Severe toxicity rates for postoperative chemoradiotherapy were 22 (48%) older adults versus 89 (45%) for younger adults (p Z 0.703), with comparable chemotherapy RDIs and radiotherapy dose. Two-year EFS was 53% for older adults versus 51% for younger adults. Conclusion: Perioperative treatment compliance, especially in the postoperative phase, was poorer in older adults compared with younger adults. As comparable proportions of patients underwent curative surgery, future studies should focus on neo-adjuvant treatment. Trial registration: ClinicalTrials.gov identifier: NCT00407186. EudraCT number: 2006 e00413032.

81 Background: Although the proportion of elderly cancer patients (pts) increases, few randomized trials provide separate results on this group. Here, we present a sub-analysis of the CRITICS trial, comparing elderly with non-elderly pts. Methods: Preoperative (preop) chemotherapy (CT) included three cycles of epirubicin, cisplatin/oxaliplatin and capecitabine (ECC/EOC); pts were upfront randomized between postoperative (postop) CT (3x ECC/EOC) and chemoradiotherapy (CRT; 45Gy + cisplatin/capecitabine). Elderly pts were defined as age ≥ 70 years at the time of randomization. We present tolerability and outcomes for elderly versus non-elderly pts. Results: Details on baseline characteristics, preop treatment, surgery, postop treatment and survival are shown in Table 1. Tumor type and localization did not differ between both groups. Conclusions: Age had a significant impact on toxicity and tolerability of preop CT, but did not affect surgical resection rates and complications. Although less elderly pts started postop treatment and elderly pts received lower dose in de CT arm, there were no differences in treatment related toxicities. Survival was not significantly different. Clinical trial information: NCT00407186. [Table: see text]

No abstract

This article is available in open access under creative common attribution-Non-commercial-No Derivatives 4.0 International (cc BY-Nc-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially