Korean J Med > Volume 87(5); 2014 > Article
The Korean Journal of Medicine 2014;87(5):521-529.
Published online November 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.87.5.521   
Chemotherapy for Advanced Gastric Cancer in Elderly Patients
Mi-Jung Kim1, Sook Ryun Park2
1Center for Gastric Cancer, National Cancer Center, Goyang, Korea
2Division of Oncology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
진행성 노인 위암에 대한 항암요법
김미정1, 박숙련2
1국립암센터 위암센터
2울산대학교 의과대학 서울아산병원 내과
Correspondence: 
Sook Ryun Park, Tel: +82-2-3010-3206, Fax: +82-2-3010-6954, Email: srpark@amc.seoul.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/bync/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Cancer, including gastric cancer, occurs predominantly in older patients. Although there is no single internationally accepted standard chemotherapy regimen for unresectable or metastatic gastric cancer (MGC), doublet combination chemotherapy using fluoropyrimidine and platinum is regarded as the reference treatment. However, most of the clinical trials that were based on the current treatment guidelines were performed in patients < 70 years of age with good performance status (PS). Therefore, the clinical application of these guidelines to elderly individuals is limited. The available data suggest that older patients with good PS are able to tolerate the same chemotherapy regimens as younger patients with MGC, and that they achieve a similar efficacy. In contrast, some studies showed that the same efficacy was achieved at the expense of increased toxicity in older patients, emphasizing the importance of patient selection. Many studies have actively investigated elderly patients with MGC, including randomized phase 3 studies comparing fluoropyrimidine and platinum doublets with fluoropyrimidine alone. Although an advanced age alone should not preclude the use of effective chemotherapy in MGC, more data regarding age-specific clinical trials are needed to guide optimal treatment in elderly patients.
Key Words: Advanced gastric cancer; Elderly; Chemotherapy
주제어: 진행성 위암; 노인; 항암화학요법


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