Comparison of Doublet and Triplet Chemotherapy Regimens in Geriatric Patients with Metastatic Gastric Cancer

Year 2025, Volume: 6 Issue: 2, 75 - 80, 28.07.2025

Yonca Yılmaz Ürün , Yaren Dirik , Nur Düzen Oflas , Gürkan Güner , Selcan Cesur , Muslih Ürün

Abstract

Introduction: There is a lack of guidelines for managing elderly metastatic gastric cancer patients. This study aimed to compare the efficacy and adverse events of doublet and triplet chemotherapy regimens in the first-line treatment of elderly patients with metastatic gastric cancer.

Methods: We retrospectively evaluated geriatric metastatic gastric cancer patients who were treated at the Van Yüzüncü Yıl University Medical Faculty between 2011 and 2021. Demographic characteristics, treatment regimens and responses, grade 3-4 toxicity, progression-free survival (PFS), and overall survival (OS) were analyzed with appropriate statistical methods.

Results: The mean age of the 224 patients was 73.8±3.6 years and 56 (25%) were female. Double-agent chemotherapy was administered to 99 (44.2%) patients, whereas 125 (55.8%) received triple-agent chemotherapy. The median OS was 9.8 months in the doublet group and 10.1 months in the triplet group (p=0.954). The median PFS was 5.8 months in the doublet group and 6.2 months in the triplet group, respectively (p=0.935). No statistically significant difference was found in terms of adverse events rates between groups.

Conclusions: In this study, triplet chemotherapy had no additional toxicity, but also did not have a significant improvement in survival. Therefore, dual regimens, which may have lower toxicity in the geriatric population, may be considered preferable.

Keywords

Chemotherapy , gastric cancer , elderly , first-line treatment

Ethical Statement

This study was conducted in accordance with the principles of the Declaration of Helsinki. The study was approved by the Ethics Committee of Van Yüzüncü Yıl University Medical Faculty (date: 16.02.2024, decision no: 2024/02-07). Because the study was designed retrospectively, no written informed consent form was obtained from patients.

Supporting Institution

None

Metastatik Mide Kanserli Geriatrik Hastalarda İkili ve Üçlü Kemoterapi Rejimlerinin Karşılaştırılması

Abstract

Giriş: Yaşlı metastatik mide kanseri hastalarının yönetimi için kılavuz eksikliği bulunmaktadır. Bu çalışmanın amacı, metastatik mide kanserli yaşlı hastaların birinci basamak tedavisinde ikili ve üçlü kemoterapi rejimlerinin etkinliğini ve yan etkilerini karşılaştırmaktır.

Yöntemler: Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi'nde 2011-2021 yılları arasında tedavi edilen geriatrik metastatik mide kanseri hastaları retrospektif olarak değerlendirildi. Demografik özellikler, tedavi rejimleri ve yanıtlar, grade 3-4 toksisite, progresyonsuz sağkalım (PFS) ve genel sağkalım (OS) uygun istatistiksel yöntemlerle analiz edildi.

Bulgular: Hastaların ortalama yaşı 73,8±3,6 idi. Çalışmaya dahil edilen 224 hastanın 56'sı (%25) kadındı. Hastaların 99'una (%44,2) ikili kemoterapi rejimi uygulanırken, 125'ine (%55,8) üçlü kemoterapi rejimi uygulandı. Ortanca OS, ikili grupta 9,8 ay ve üçlü grupta 10,1 aydı (p=0,954). Ortanca PFS sırasıyla ikili grubunda 5,8 ay ve üçlü grupta 6,2 aydı (p=0,935). Advers olay oranları açısından gruplar arasında istatistiksel olarak anlamlı bir fark bulunmamıştır.

Sonuç: Bu çalışmada, üçlü kemoterapinin ek toksisiteye neden olmadığı ancak sağkalımı da önemli ölçüde iyileştirmediği bulunmuştur. Bu nedenle, geriatrik popülasyonda daha düşük toksisiteye sahip olabilecek ikili rejimler tercih edilebilir.

Keywords

Kemoterapi , mide kanseri , geriatri , birinci basamak tedavi

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