In a nutshell
This study compared a 3-month with a 6-month chemotherapy treatment after colon cancer surgery. Researchers suggested that the duration of the treatment should be chosen according to the patient condition.
Colorectal cancer is one of the most common cancers worldwide. Stage 2 and 3 colon cancer are common and curable cancers. However, these patients are considered high risk due to the possibility of metastasis (spread to other parts of the body).
The standard treatment used to be a long-course of 5-Fluorouracil/leucovorin (5-FU/LV). However, this treatment is associated with high rates of negative side effects. Therefore, a shorter duration of treatment, with the same effectiveness and reduced toxicity was necessary.
The current standard treatment for these cancers is surgery and chemotherapy. FOLFOX4 (oxaliplatin, folinic acid, fluorouracil) or CAPOX (capecitabine, oxaliplatin) are currently used chemotherapy regimens. Prior studies showed that this chemotherapy is associated with improved outcomes when compared to 5FU/LV. However, the duration of the treatment is still not clear.
Methods & findings
This study included 1115 patients with colon cancer. 413 had stage 2 and 702 had stage 3 colon cancer. The average follow-up period was 67 months. Patients were assigned to receive CAPOX or FOLFOX for 3 (group 1) and 6 months (group 2). In other words, 4 or 8 cycles of CAPOX and 6 or 12 cycles of FOLFOX.
The overall 3-year disease-free survival (DFS; time from treatment to disease progression) for group 1 was 77.2% and for group 2 was 77.9%.
The 3-year DFS for stage 2 patients in group 1 receiving FOLFOX was 76.7% and 79.3% for group 2. For patients receiving CAPOX, this rate was 85.4% for group 1 and 83.8% for group 2.
The 3-year DFS for stage 3 patients in group 1 receiving FOLFOX was 71.5% and for group 2 was 77.3%. While for patients receiving CAPOX was 74.5% for group 1 and 74.7% in group 2.
The bottom line
This study concluded that the 3-year DFS is affected by the treatment chosen. This decision should be made considering the condition of each patient.
Published By :
Annals of oncology: official journal of the European Society for Medical Oncology
Jun 22, 2019
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