Here is a recent study which may give you a bit more info on the topic of geriatric use of capecitabine (Xeloda)
= "oral" chemo version of a 5FU, which is a
pro-drug, the body metabolizes into active chemo
http://www.current-oncology.com/index.p ... /3516/2499Conclusions
Toxicity is less with dose-reduced capecitabine than with historical full-dose capecitabine, with only a small trade-off in efficacy, seen as a lower objective response rate. The improved tolerability could lead to an increased number of cycles of therapy, and pfs appears to be consistently higher at the lower dose. Those observations should, in the absence of a head-to-head clinical trial, be viewed as compelling evidence that 1000 mg/m2, or even 750 mg/m2, twice daily is an appropriate dose in elderly or frail patients with acrc.
Their use of a lower dose does target lower side effects with little change in efficacy, and even considers the use of longer term treatment with overall higher progression free survivals.
MY input :
I had oral chemo with Xeloda, with various doses, before and after resection = tolerable for a 55 - 59 year old Stage IV patient
My father (86) did not do well on his chemo for mesothelioma (( a different chemo )) but was OK with surgery and IMRT radiation therapy.
I believe that stronger chemo = FOLFOX would not likely benefit your Dad's quality of life at his age = JMO.
I was there to advocate ...VOCALLY and aggressively for my father .... so if you can be there too,
maybe consider the lower dose oral chemo and remember
... IT IS HIS BODY AND HIS LIFE .. so if Dad says ENOUGH ! ...
you can always reduce the dose more, change options .... or quit, it is
HIS decision.
Another point I have to mention :
80 year old patient ..... the docs will be looking at and SHOULD be talking with you/Dad about the "benefit" of doing chemo at his age
REGARDLESS of efficacy / toxicity etc.
sorry just the way the medical system works and I believe you may have encountered this thought process :
how long would the patient live without advanced treatments ?
how long would the patient live with advanced treatments ?
what is the "cost" = toll on the patient to DO treatment ? ... at what benefit
what is the "cost" = toll on the patient to NOT DO treatment ?... at what benefit I have walked in your shoes as caregiver
I am still "walking" in your father's shoes today as patient
PM me anytime as this is not an easy path you are on
BUTT ... you have friends here
Harmony
CRguy