Adjuvant Chemotherapy Use and Adverse Events Among Older Patients With Stage III Colon Cancer

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Abstract
Randomized trials have shown reductions in cancer death and recurrence in patients with stage III colon cancer treated with adjuvant chemotherapy.1-4 A pooled analysis of trials comparing fluorouracil and leucovorin or levamisole against no adjuvant chemotherapy reported a 24% reduction in mortality and a 32% reduction in disease recurrence across all age categories of chemotherapy users, indicating that the effectiveness of adjuvant chemotherapy with fluorouracil–based regimens is similar in older and younger patients.5 Based on selected patients accrued to clinical trials, several analyses have shown a disease-free survival advantage associated with the addition of oxaliplatin to standard fluorouracil and leucovorin but with increased toxicity, which does not appear to vary by age.4,6,7