Clinical Outcome in Elderly Patients (Aged ≥ 65 Years) Treated with Chemotherapy for Advanced Soft Tissue Sarcomas: A Tokai Musculoskeletal Oncology Consortium Study

Background/Objectives: Chemotherapy is recommended for patients with advanced soft tissue sarcoma (STS). However, chemotherapy is less aggressive in elderly patients than in younger patients owing to comorbidities and other health problems. This multicenter study aimed to examine the outcomes of elderly patients treated with chemotherapy for advanced STS. Methods: The study cohort included 60 men and 71 women with a mean age of 73 years. The mean follow-up duration was 22.9 months. Results: As first-line treatment, the doxorubicin-containing regimen was the most frequently used. Dose reduction was more frequent in patients aged ≥ 75 years than in those aged ≤ 74 years. Complete response occurred in two patients and partial response in eight patients. The objective response rate was 8.2%. The 1- and 2-year survival rates after first-line chemotherapy were 61.8% and 40.2%, respectively. The median survival time was 19 months. In multivariate analysis, patients with performance status (PS) 2 or 3 had poorer survival than those with PS 0 or 1. The median survival times for patients with PS 0 or 1 and PS 2 or 3 were 22.1 and 4.3 months, respectively. Among 131 patients, no fatal adverse events occurred, although chemotherapy was discontinued due to adverse events in 28 patients. Conclusions: Chemotherapy for advanced STS in elderly patients may be effective in those with good PS, although it should be considered to evaluate the benefits and risks of cytotoxic chemotherapy.