[Cancer chemotherapy in patients of advanced age (over 75)]

Generally, elderly patients are excluded from therapeutic trials because of decreased tolerance to chemotherapy. We discussed chemotherapy cancer patients of an advanced age based on our experience of malignant lymphoma and advanced gastric cancer patients over 75 years of age. We found the tendencies for diagnosis at more advanced stages involved many complications, especially 10% of cases have double cancer, and not good performance status in these patients. Some 53 cases of malignant lymphoma were treated with combination chemotherapy including anthracycline, obtained prolongation of survival in responder. On the other hand, 64 cases of advanced gastric cancer were treated with palliative chemotherapy. Some clinical trials have showed that older and younger patients were no different in terms of response, toxicity and overall survival. But these selected elderly patients could be entered in clinical trials, seemed to have to have surprisingly good health, no historical complications and good performance status, in spite of suffering from cancer. Not only chronological age but also the kinds of cancer and performance status are important justification for decisions to limit or withhold treatment.