Incorporating neoadjuvant chemotherapy into locally advanced colon cancer treatment pathways: Real-life experience of implementing FOxTROT.

Autor: Williams CJ; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.; Leeds Institute of Medical Research, St James's, School of Medicine, University of Leeds, Leeds, UK., Fish R; Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Cancer Research Centre, Manchester, UK.; Colorectal and Peritoneal Oncology Centre, Christie NHS Foundation Trust, Manchester, UK., Akerman L; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK., West N; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.; Leeds Institute of Medical Research, St James's, School of Medicine, University of Leeds, Leeds, UK., Tolan D; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.; Leeds Institute of Medical Research, St James's, School of Medicine, University of Leeds, Leeds, UK., Quyn AJ; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.; Leeds Institute of Medical Research, St James's, School of Medicine, University of Leeds, Leeds, UK., Seligmann JF; Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK.; Leeds Institute of Medical Research, St James's, School of Medicine, University of Leeds, Leeds, UK.
Jazyk: angličtina
Zdroj: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2023 Mar; Vol. 25 (3), pp. 352-356. Date of Electronic Publication: 2023 Feb 06.
DOI: 10.1111/codi.16450
Abstrakt: Aim: The international FOxTROT trial, recently published in the Journal of Clinical Oncology is the first randomized controlled trial testing neoadjuvant chemotherapy (NAC) with oxaliplatin and 5-fluorouracil in locally advanced, but operable, colon cancer. The trial met its primary endpoint with fewer patients experiencing recurrent or residual disease at 2 years with NAC compared with the control (16.8% vs. 21.2%, risk ratio = 0.74, p  = 0.042). Translating the findings of the FOxTROT trial into improved patient outcomes is dependent on implementation of new neoadjuvant chemotherapy (NAC) pathways in colorectal cancer.
Method: We describe our experience implementing a novel neoadjuvant treatment pathway in colorectal cancer at a large UK teaching hospital.
Results: To date 64 patients have been commenced on the novel pathway following presentation and adoption of the FOxTROT trial results. We present key lessons and strategies developed across the multidisciplinary team to minimize impact on person hours, service capacity and budget, whilst building patient safety and confidence.
Conclusion: Use of NAC for locally advanced colon cancer has been shown to improve surgical outcomes and longer term cancer outcomes. Provision of NAC requires some modifications to current treatment pathways but can be delivered with team working and without the requirement for additional resources.
(© 2022 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.)
Databáze: MEDLINE
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