Colorectal cancer is one of the top causes of cancer-related deaths in the world, and more and more older adults are being diagnosed with it.
One big question doctors face is whether an extra chemotherapy drug called oxaliplatin is helpful for older patients.
This drug is commonly added to regular chemotherapy, but it often causes serious side effects, especially in older people.
To explore this issue, researchers from Korea University, including Dr. Jun Woo Bong, Dr. Hwamin Lee, and Dr. Seogsong Jeong, looked into the health records of over 8,500 patients in South Korea. These people had stage II or stage III colorectal cancer and had surgery followed by chemotherapy between 2014 and 2016.
The patients were split into two groups—those who received oxaliplatin along with other chemotherapy drugs and those who did not. The researchers wanted to find out if there was an age when the risks of this drug outweighed the benefits.
The results were very clear. For people with stage III colorectal cancer who were 70 years old or younger, adding oxaliplatin reduced the risk of death by 41%. Their chances of surviving five years went up from 78% to almost 85%. But for those older than 70, the drug didn’t help them live longer.
In fact, nearly 40% of older patients who got oxaliplatin had to stop their treatment early, mostly because of side effects like nerve pain or extreme tiredness. For people with stage II cancer, no matter their age, the drug didn’t improve survival rates at all.
Dr. Bong explained that the main takeaway is simple: oxaliplatin helps younger patients with stage III cancer, but not older ones. And for older patients, it often causes more harm than good.
Dr. Jeong added that this finding can help doctors make better decisions. If a patient is over 70, doctors might decide not to give oxaliplatin to avoid unnecessary suffering. This approach can make treatment safer and more comfortable for older patients.
There’s also a bigger picture. Choosing not to use oxaliplatin when it isn’t effective can help save money, reduce hospital visits, and allow doctors to focus on treatments that really work. This research might even change international cancer care guidelines in the future.
Dr. Lee pointed out that clinical guidelines may soon include age 70 as a key factor in deciding whether to use oxaliplatin. This would support more personalized treatment plans that match each patient’s age and overall health.
The study does have a few limits. For example, it looked back at old records and didn’t include detailed biological data about the patients. Still, the large number of people involved makes the findings strong and reliable.
As cancer care moves toward more personalized treatment, this study is a good reminder that doctors should consider both the stage of the cancer and the age of the patient.
For younger patients, oxaliplatin can be a powerful tool. But for those over 70, it might be better to skip it and focus on treatments that offer a better balance between living longer and feeling better.
The study is published in JAMA Network Open.
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