Optimize the dose of oxaliplatin for locally advanced rectal cancer treated with neoadjuvant chemoradiotherapy followed by radical surgery and adjuvant chemotherapy

Autor: Wu Jiang, Shi-Liang Liu, Wei-Jun Ye, Yalan Tao, Chen Chen, Hui Chang, Yuanhong Gao
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Cancer Research
Survival
Colorectal cancer
Kaplan-Meier Estimate
Gastroenterology
Metastasis
0302 clinical medicine
Antineoplastic Combined Chemotherapy Protocols
030212 general & internal medicine
Neoplasm Metastasis
Proctectomy
Incidence
Hazard ratio
Middle Aged
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Neoadjuvant Therapy
Oxaliplatin
Oncology
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Distant metastasis
Female
Research Article
medicine.drug
Adult
medicine.medical_specialty
Adolescent
Drug-Related Side Effects and Adverse Reactions
Rectal neoplasms
lcsh:RC254-282
Disease-Free Survival
Drug Administration Schedule
Capecitabine
Young Adult
03 medical and health sciences
Internal medicine
Genetics
medicine
Humans
Radical surgery
Aged
Neoplasm Staging
Photons
Dose-Response Relationship
Drug
Proportional hazards model
business.industry
Rectum
Chemoradiotherapy
Adjuvant
medicine.disease
Regimen
Neoplasm Recurrence
Local
Radiotherapy
Conformal
business
Follow-Up Studies
Zdroj: BMC Cancer, Vol 20, Iss 1, Pp 1-10 (2020)
BMC Cancer
ISSN: 1471-2407
DOI: 10.1186/s12885-020-06988-x
Popis: Background Addition of oxaliplatin to capecitabine remains controversial for locally advanced rectal cancer (LARC). And cumulative oxaliplatin dose (COD) varied among clinical trials showing different therapeutic effects of this regimen. The objective of this study was to explore how COD affected tumor metastasis and patient survival. Methods Totally 388 patients diagnosed with stage cII-III rectal cancer and treated with neoadjuvant chemoradiotherapy followed by radical surgery plus adjuvant chemotherapy were consecutively enrolled into this study and retrospectively reviewed. After grouping by total chemotherapy cycle (TCC), influences of COD on adverse effects and patients’ survivals were analyzed in each group. Univariate and multivariate survival analyses were performed through Kaplan-Meier approach and COX proportional hazards model, respectively. Age, gender, anemia, differentiation, carcinoembryonic antigen, carbohydrate antigen 19–9, pretreatment clinical stage and postsurgical pathologic stage were used as covariates. Results COD 2 emerged as an independent predictor of poorer overall, metastasis-free and disease-free survivals, in patients treated with TCC ≤ 7. The hazard ratios were 1.972, 1.763 and 1.637 (P values were 0.021, 0.028 and 0.041), respectively. But it was note-worthy that COD ≥460 mg/m2 increased incidence of acute toxicities from 38.4 to 70.8% (P Conclusions For LARC patients treated with insufficient TCC (≤ 7), oxaliplatin of ≥460 mg/m2 might be needed to improve survival, though it might resulted in more acute toxicities.
Databáze: OpenAIRE
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