Chemotherapy in colorectal cancer - Which therapy is justified in elderly patients?

Treating elderly patients with colorectal cancer is a challenging task for which many aspects have to be taken into account. 70% of patients with colo rectal cancer are 65 years or older and the number of elderly patients is e xpected to increase. As elderly patients frequently exhibit adverse physica l or socio-economic conditions, a thorough geriatric assessment of the pati ent's suitability for therapy is essential before making a decision. At pre sent, adjuvant 5-FU based chemotherapy (in colon cancer) and adjuvant radio -chemotherapy (in rectal cancer) in the elderly is recommended for locally advanced or node positive tumor after tumor resection,since the benefit may be comparable to that achieved in younger patients. There is enough data t o support the use of 5-FU based chemotherapy in elderly patients in the pal liative setting. New substances have recently been added to the armentarium for metastatic colorectal cancer. However, there is as yet not sufficient data to guide the use of these new drugs (such as oxaliplatin or irinotecan ) in elderly patients. However, first clinical studies seem to indicate a c omparable efficacy and toxicity in elderly patients to that observed in you nger patients. Further clinical trials of chemotherapy in elderly patients with colorectal cancer are necessary to gain information about treatment re commendations.