In a nutshell
This study compared the effectiveness and safety of low and high dose leucovorin (folinic acid) in the treatment of colorectal cancer. Researchers suggested that low dose leucovorin might be a safe treatment option for these patients.
Some background
Colorectal cancer is the fourth leading cause of death by cancer. This cancer frequently progresses to the metastatic (spread to other parts of the body) stage. The standard treatment is fluorouracil-based chemotherapy. Prior studies have reported that leucovorin (LEU) increases the action of fluorouracil.
Between 2008 and 2012 occurred an LEU shortage due to an increasing demand. This had an impact on chemotherapy treatments with LEU. In 2011 it was suggested to lower the LEU standard dose. After the shortage, some institutions went back to the standard dose, and others did not.
Prior studies show conflicting results when investigating high and low doses of LEU. Some say that LEU improves survival, but others show no difference between high and low dose. Therefore, the effectiveness of a low dose of LEU is still not known.
Methods & findings
This study reviewed 12 other studies. These studies had a range of participants between 58 and 4927. These patients had advanced colorectal cancer and received treatment with a high or low dose of LEU.
The average survival time was similar between the two dose levels. Patients who received the high dose of LEU had an improvement of 19% in the odds of a better tumor response. No significant difference in toxicity was seen between the two dose levels. However, there were fewer diarrhea events in the low dose group.
The bottom line
This study concluded that low dose of LEU may be an equally good treatment option for patients with colorectal cancer.
The fine print
Some of the reviewed studies had a limited number of participants. Further studies with a bigger population are needed.
Published By :
Colorectal Disease
Date :
Jul 01, 2019
