Prolongation of survival and improvement in performance status following palliative chemotherapy in gastrointestinal cancer patients with a poor performance status

Abstract

Background: The prognosis of advanced gastrointestinal cancer, especially in patients with poor performance status (PS), is generally dismal. Patients with PS 3-4 are almost ineligible for participation in clinical studies.

Patients and methods: From June 2000 to February 2007, 116 patients with poor PS (PS 3 = 73 and PS 4 = 43) were treated with chemotherapy. Retrospective analysis was performed.

Results: Of the 107 patients with at least one measurable lesion, a partial response was obtained in 15 patients (14.0%). Of 65 patients with ascites and/or pleural effusion, 12 patients achieved decreased fluid accumulation. A decline in tumor markers was observed in 30 patients. As a result, 38 patients (32.7%) achieved tumor response, a decrease in fluid accumulation or a decline in tumor markers (responders), which resulted in a survival benefit compared to the other 78 patients without effect (6.9 vs. 2.2 months, p < 0.001). PS improvement was seen in 16 patients (13.8%).

Conclusions: The results suggest that chemotherapy may be beneficial in gastrointestinal cancer patients with poor PS, as demonstrated by a certain degree of improvement in PS and survival in responders. Further study is required to confirm the benefit of chemotherapy in this patient population.