Adjuvant chemotherapy in stage II-III operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified CAPOX.
Adjuvant chemotherapy
CAPOX
India
colon cancer
compliance
Journal
South Asian journal of cancer
ISSN: 2278-330X
Titre abrégé: South Asian J Cancer
Pays: India
ID NLM: 101618774
Informations de publication
Date de publication:
Historique:
entrez:
7
9
2019
pubmed:
7
9
2019
medline:
7
9
2019
Statut:
ppublish
Résumé
Data regarding the practice of adjuvant chemotherapy, specifically with modified CAPOX, and survival outcomes in operated colon cancer patients from a nontrial cohort in a lower-middle income and low prevalence nation like India is scarce. Patients who underwent upfront curative resection for colon cancer from January 2013 to December 2016 were analyzed for baseline variables and outcomes. A total of 491 patients underwent curative resection in the predefined time period. The median age of the patients was 53 years (range: 17-87). Patients with Stage I, Stage II, and Stage III disease comprised 7.9%, 44.8%, and 45.4% of the entire cohort, respectively. Patients with Stage I cancer were observed. Adjuvant chemotherapy was planned for 384 patients (78.2%), with the doublet regimens (capecitabine-oxaliplatin, or 5-fluorouracil-oxaliplatin) being used commonly (77.6%). Common toxicities were Hand-foot syndrome (Grade 2/3 - 21.4%) and peripheral neuropathy (Grade 2/3 - 20.1%). About 85% of patients receiving monotherapy (capecitabine or 5 fluorouracil) and 81.2% of patients receiving doublet chemotherapy (mCAPOX or modified FOLFOX-7) completed their planned adjuvant treatment. With a median follow-up of 22 months, estimated 3 years event-free survival was 86%, and overall survival (OS) was 93.6%. Stage, younger age (<50 years), underlying cardiovascular abnormalities, need for dose reductions and noncompletion of planned chemotherapy predicted for inferior estimated 3-year OS on multivariate analysis. Adjuvant chemotherapy especially with modified CAPOX appears well tolerated in the Indian population and early survival outcomes appear to be comparable to published literature.
Sections du résumé
BACKGROUND
BACKGROUND
Data regarding the practice of adjuvant chemotherapy, specifically with modified CAPOX, and survival outcomes in operated colon cancer patients from a nontrial cohort in a lower-middle income and low prevalence nation like India is scarce.
MATERIALS AND METHODS
METHODS
Patients who underwent upfront curative resection for colon cancer from January 2013 to December 2016 were analyzed for baseline variables and outcomes.
RESULTS
RESULTS
A total of 491 patients underwent curative resection in the predefined time period. The median age of the patients was 53 years (range: 17-87). Patients with Stage I, Stage II, and Stage III disease comprised 7.9%, 44.8%, and 45.4% of the entire cohort, respectively. Patients with Stage I cancer were observed. Adjuvant chemotherapy was planned for 384 patients (78.2%), with the doublet regimens (capecitabine-oxaliplatin, or 5-fluorouracil-oxaliplatin) being used commonly (77.6%). Common toxicities were Hand-foot syndrome (Grade 2/3 - 21.4%) and peripheral neuropathy (Grade 2/3 - 20.1%). About 85% of patients receiving monotherapy (capecitabine or 5 fluorouracil) and 81.2% of patients receiving doublet chemotherapy (mCAPOX or modified FOLFOX-7) completed their planned adjuvant treatment. With a median follow-up of 22 months, estimated 3 years event-free survival was 86%, and overall survival (OS) was 93.6%. Stage, younger age (<50 years), underlying cardiovascular abnormalities, need for dose reductions and noncompletion of planned chemotherapy predicted for inferior estimated 3-year OS on multivariate analysis.
CONCLUSIONS
CONCLUSIONS
Adjuvant chemotherapy especially with modified CAPOX appears well tolerated in the Indian population and early survival outcomes appear to be comparable to published literature.
Identifiants
pubmed: 31489288
doi: 10.4103/sajc.sajc_176_18
pii: SAJC-8-160
pmc: PMC6699238
doi:
Types de publication
Journal Article
Langues
eng
Pagination
160-165Déclaration de conflit d'intérêts
There are no conflicts of interest.
Références
J Am Coll Surg. 2016 Jan;222(1):19-29.e2
pubmed: 26721750
J Clin Oncol. 1997 Jan;15(1):246-50
pubmed: 8996149
Indian J Endocrinol Metab. 2013 Sep;17(5):806-14
pubmed: 24083161
Lancet Oncol. 2014 May;15(6):e205-12
pubmed: 24731885
J Clin Oncol. 2015 Dec 10;33(35):4176-87
pubmed: 26527776
Indian J Surg Oncol. 2017 Dec;8(4):484-490
pubmed: 29203978
Br J Cancer. 2016 Sep 27;115(7):887-94
pubmed: 27584663
Indian J Surg Oncol. 2017 Dec;8(4):491-498
pubmed: 29203979
Ann Oncol. 2013 Oct;24 Suppl 6:vi64-72
pubmed: 24078664
Colorectal Dis. 2009 May;11(4):354-64; discussion 364-5
pubmed: 19016817
PLoS One. 2015 Mar 19;10(3):e0121944
pubmed: 25789685
Clin Colon Rectal Surg. 2015 Dec;28(4):256-61
pubmed: 26648796
World J Gastroenterol. 2014 Jun 14;20(22):6809-14
pubmed: 24944470
Semin Oncol. 2011 Aug;38(4):511-20
pubmed: 21810510
Croat Med J. 2013 Dec;54(6):532-40
pubmed: 24382847
Oncologist. 2011;16(5):708-16
pubmed: 21478275
Ecancermedicalscience. 2012;6:243
pubmed: 22423250
Ann Surg Oncol. 2012 Sep;19(9):2814-21
pubmed: 22476818
Indian J Gastroenterol. 2011 Feb;30(1):3-6
pubmed: 21222189
J Postgrad Med. 2003 Jul-Sep;49(3):222-8
pubmed: 14597785
ESMO Open. 2016 Nov 14;1(5):e000087
pubmed: 27900205
World J Gastrointest Oncol. 2015 Dec 15;7(12):383-8
pubmed: 26689921
J Clin Oncol. 2007 Jun 1;25(16):2198-204
pubmed: 17470851
Eur J Cancer. 2001 Jul;37(11):1402-8
pubmed: 11435072
Colorectal Dis. 2010 Oct;12(10 Online):e182-9
pubmed: 20128837
J Clin Oncol. 2003 Aug 1;21(15):2896-903
pubmed: 12885807
J Clin Oncol. 2013 Jul 20;31(21):2699-707
pubmed: 23775951
Curr Colorectal Cancer Rep. 2013;9:261-269
pubmed: 24032000
World J Gastrointest Oncol. 2016 Dec 15;8(12):819-825
pubmed: 28035252
N Engl J Med. 2003 Jul 17;349(3):247-57
pubmed: 12867608
Acta Oncol. 2015 Jan;54(1):5-16
pubmed: 25430983
J Clin Oncol. 2009 Jul 1;27(19):3109-16
pubmed: 19451431
Medicine (Baltimore). 2014 Nov;93(23):e135
pubmed: 25415667
Cancer Chemother Pharmacol. 2010 Sep;66(4):659-67
pubmed: 20033812
J Clin Oncol. 2013 Jul 10;31(20):2600-6
pubmed: 23733765
J Geriatr Oncol. 2015 Mar;6(2):133-40
pubmed: 25666905
J Clin Oncol. 2011 Apr 10;29(11):1465-71
pubmed: 21383294
J Clin Oncol. 2016 Apr 20;34(12):1297-9
pubmed: 26903571