Evaluation of Adjuvant Short CAPOX Followed by Capecitabine for Stage III Colon Cancer

Q4 Medicine
Eman S. El. Banna, Marwa M. Hussein, Yahia M. Ismail, Ghada M. Sherif, Mostafa M. El.Serafi
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引用次数: 0

Abstract

Background: Since 2004, 6 months of postsurgical adjuvant chemotherapy with combination of 5-FU/LV or oral Capecitabine and Oxaliplatin has been the standard of care worldwide for patients with stage III colon cancer. Objectives: to evaluate the efficacy of 3-months of Capecitabine and Oxaliplatin (CAPOX) followed by 3 months Capecitabine alone as adjuvant treatment in stage III colon cancer. Methods: This is a prospective study that included 50 patients with stage III colon cancer who presented to National Cancer Institute, Cairo University to receive adjuvant CAPOX for three months followed by three months Capecitabine alone where disease free survival (DFS) & overall survival (OS) and toxicity were evaluated. Results: The median age of patients was 43 years (range: 21-70) with male predominance. The majority of patients (70%) had right-sided lesions and N1 stage (64%). After a median follow up period of 36.8 months (range: 9.5-50.8); the 3-year cumulative DFS & OS were 57.2 & 86.3% respectively. Patients’ age, presence of comorbidity, higher grade, development of chemotherapy-related peripheral neuropathy (PN), N2 stage, perineural invasion (PNI) and lymph node ratio (LNR) > 0.25 were significantly associated with worse DFS whereas, the latter two were significantly related to worse OS. Diarrhea, vomiting, hand-foot syndrome and PN were the most common grade 3 toxicities. The latter was significantly higher in patients with preexisting diabetes. Conclusion: This small phase II study suggests that shorter duration of adjuvant oxaliplatin in stage III colon cancer might be associated with less toxicity especially peripheral neuropathy but still shows comparable survival to the six-months regimen. Further larger scale prospective randomized trial is mandatory to confirm these results.
辅助短CAPOX加卡培他滨治疗III期结肠癌的评价
背景:自2004年以来,术后6个月的5-FU/LV联合化疗或口服卡培他滨和奥沙利铂已成为全球III期结肠癌患者的标准治疗方案。目的:评价卡培他滨联合奥沙利铂(CAPOX)治疗3个月后单独卡培他滨辅助治疗III期结肠癌的疗效。方法:这是一项前瞻性研究,纳入了50名III期结肠癌患者,他们在开罗大学国家癌症研究所接受了3个月的辅助CAPOX治疗,然后单独使用卡培他滨3个月,评估无病生存期(DFS)和总生存期(OS)和毒性。结果:患者中位年龄43岁(范围21-70岁),男性居多。大多数患者(70%)为右侧病变,N1期(64%)。中位随访期为36.8个月(范围:9.5-50.8个月);3年累计DFS和OS分别为57.2%和86.3%。患者年龄、是否存在合并症、分级较高、有无化疗相关周围神经病变(PN)、N2分期、神经周围浸润(PNI)、淋巴结比(LNR) > 0.25与较差的DFS显著相关,后两者与较差的OS显著相关。腹泻、呕吐、手足综合征和PN是最常见的3级毒性。后者在先前存在糖尿病的患者中明显更高。结论:这项小型II期研究表明,奥沙利铂辅助治疗III期结肠癌的时间较短,毒性更小,尤其是周围神经病变,但仍显示出与6个月方案相当的生存期。需要进一步的大规模前瞻性随机试验来证实这些结果。
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来源期刊
Surgery, Gastroenterology and Oncology
Surgery, Gastroenterology and Oncology Medicine-Gastroenterology
CiteScore
0.30
自引率
0.00%
发文量
11
期刊介绍: Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.
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