Impact of Relative Dose Intensity of FOLFOX Adjuvant Chemotherapy on Risk of Death Among Stage III Colon Cancer Patients.

Autor: Zhou M; Epidemiology Program, School of Public Health and Louisiana Tumor Registry, Louisiana State University Health Sciences Center, New Orleans, LA., Thompson TD; Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA., Lin HY; Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA., Chen VW; Epidemiology Program, School of Public Health and Louisiana Tumor Registry, Louisiana State University Health Sciences Center, New Orleans, LA., Karlitz JJ; Division of Gastroenterology, School of Medicine, Tulane University; Gastroenterologist Southeast Louisiana Veteran Health Care System, New Orleans, LA., Fontham ETH; Epidemiology Program, School of Public Health and Louisiana Tumor Registry, Louisiana State University Health Sciences Center, New Orleans, LA., Theall KP; Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA., Zhang L; Department of Public Health Sciences, Clemson University, Clemson, SC., Hsieh MC; Epidemiology Program, School of Public Health and Louisiana Tumor Registry, Louisiana State University Health Sciences Center, New Orleans, LA., Pollack LA; Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA., Wu XC; Epidemiology Program, School of Public Health and Louisiana Tumor Registry, Louisiana State University Health Sciences Center, New Orleans, LA. Electronic address: xwu@lsuhsc.edu.
Jazyk: angličtina
Zdroj: Clinical colorectal cancer [Clin Colorectal Cancer] 2022 Jun; Vol. 21 (2), pp. e62-e75. Date of Electronic Publication: 2021 Oct 01.
DOI: 10.1016/j.clcc.2021.09.008
Abstrakt: Background: The National Comprehensive Cancer Network (NCCN) guidelines have recommended tailored chemotherapy for stage III high-risk (T4 and/or N2) and low-risk (T1-T3 and N1) colon cancer since 2018. Studies have investigated the effect of relative dose intensity (RDI) of FOLFOX on stage III colon cancer survival, however, none has performed a stratified analysis by risk profiles. This study aims to identify the FOLFOX optimal RDI for high-risk and low-risk stage III colon cancer patients.
Methods: Data on 407 eligible patients, diagnosed with stage III colon cancer in 2011 who received FOLFOX, were collected by 8 population-based cancer registries. Multivariable Cox model and Fine-Gray competing risks model were employed to explore Optimal RDI defined as the lowest RDI administered without significant differences in either overall or cause-specific death.
Results: Among the 168 high-risk patients, the optimal RDI cut-off was 70% (HR = 1.59 with 95% CI: 0.69-3.66 in overall mortality; HR = 1.24 with 95% CI: 0.42-3.64 in cause-specific mortality when RDI < 70% vs. RDI ≥ 70%). Among the 239 low-risk patients, none of the evaluated cut-offs were associated with significant differences in risk of death between comparison groups. The lowest assessed RDI was 45%, HR = 0.80; 95% CI: 0.24 to 2.73 for overall mortality and HR = 0.53; 95% CI: 0.06 to 4.95 for cause-specific mortality, when RDI <45% versus RDI ≥45%.
Conclusions: There is no significant harm on the risk of death when reducing RDI by <30% for high-risk patients. For the low-risk patients, we found that RDI as low as 45% did not significantly affect the risk of death.
(Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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