In a nutshell
The aim of this study was to assess the effects of pauses during chemotherapy in patients with advanced colorectal cancer (CRC).
Some background
In advanced CRC (cancer of the large bowel that has spread to the lymph nodes and other tissues and organs of the body) the cancer is more difficult to remove. Patients usually need many rounds of chemotherapy. Standard chemotherapy for patients with advanced CRC includes drugs like oxaliplatin (Eloxatin) and 5-fluorouracil (Efudex). However, intensive chemotherapy can result in serious side effects, which can have a big influence on the patients’ quality of life. The authors of this study evaluated whether making pauses in the chemotherapy treatment can have the same effect on the cancer with less side effects to the rest of the body.
Methods & findings
Between 2005 and 2008, 1614 CRC patients were included in the study. They were randomly assigned to receive either continuous oxaliplatin-based chemotherapy (group A), or intermittent chemotherapy for 12 weeks (group B). Group A received chemotherapy until the cancer progressed or the patients decided to stop, while in group B chemotherapy was stopped after the 12 weeks of treatment. The intermittent strategy was that the same therapy was to be restarted if the disease progressed.
After approximately 2 years of follow up, the average survival for patients in group A was 19.6 months, compared to 18 months in group B. Among the patients in group B, the median time until disease progression was 12.9 weeks. 64% of these patients restarted therapy for another 12 weeks, with a median chemotherapy-free interval before progression of 16 weeks. Of these, 32% had a partial response, 38% had stable disease and 30% had progressive disease. The most common side effects for patients receiving continuous therapy were low count of blood elements and reddening, swelling, numbness of the hands and feet (known as hand-food syndrome). In the intermittent therapy group nausea and vomiting were more frequent. Significant benefits were registered at 24 weeks in patients receiving intermittent treatment regarding quality of life and social functioning.
The bottom line
In conclusion this study has shown that intermittent chemotherapy was associated with improved quality of life, fewer side effects and shortened time on chemotherapy in patients with advanced CRC. Also, the difference on survival was not significant when compared with continuous therapy.
What’s next?
Talk to your doctor to see which chemotherapy regimen best fits your situation.
Published By :
Lancet oncology
Date :
Jun 04, 2011
