This study investigated the effects of CAPOX chemotherapy (oxaliplatin plus capecitabine) or capecitabine (Xeloda) alone on survival of elderly stage 3 colon cancer patients. Researchers suggested that both CAPOX or capecitabine alone were associated with an improved survival. 

Chemotherapy is the standard treatment for patients with stage 3 colon cancer. The combination of oxaliplatin chemotherapy with capecitabine (CAPOX) was previously shown to improve survival in these patients. However, this combination was associated with higher rates of negative side effects. More than half of colon cancer patients are considered elderly (70 years or older). Studies examining treatment with capecitabine and oxaliplatin in elderly patients were not conclusive.

The objective of this study was to investigate the effects of CAPOX and capecitabine alone on survival of elderly stage 3 colon cancer patients. Additionally, this study also investigated whether oxaliplatin treatment benefits elderly patients and how the non-completion of both treatments (due to toxicity) affects survival.

Patients aged 70 or more years that underwent surgery only (630) or who received treatment with CAPOX (191) or capecitabine (161) alone after surgery were included in this study. Recurrence-free survival (RFS; time from treatment to return of cancer) and overall survival (OS; time from treatment to death by any cause) were determined.

5-years RFS and OS were not different between capecitabine (RFS: 63%; OS: 66%) and CAPOX (RFS: 60%; OS: 66%). For patients who underwent surgery alone RFS was 38% and OS was 37%.

48% of the patients completed the treatment with CAPOX and 68% with capecitabine. 3-years RFS and OS did not differ in patients who did and did not complete the treatment with CAPOX. Treatment with capecitabine was associated with improved RFS and OS in patients who completed the treatment (RFS: 72%; OS: 80%) compared with the patients who did not (RFS: 54%; OS: 65%). 

This study concluded that combined CAPOX treatment and treatment with capecitabine alone are associated with improved RFS and OS. Completion of treatment was associated with better outcomes in patients treated with capecitabine.