Munker, Stefan and Gerken, Michael and Fest, Petra and Ott, Claudia and Schnoy, Elisabeth and Fichtner-Feigl, Stefan and Wiggermann, Philipp and Vogelhuber, Martin and Herr, Wolfgang and Stroszczynski, Christian and Schlitt, Hans Juergen and Evert, Matthias and Reng, Michael and Klinkhammer-Schalke, Monika and Teufel, Andreas (2018) Chemotherapy for metastatic colon cancer: No effect on survival when the dose is reduced due to side effects. BMC CANCER, 18: 455. ISSN 1471-2407,
Full text not available from this repository. (Request a copy)Abstract
Background: 5-Fluorouracil (5FU), Folinic acid (FA), and Oxaliplatin (FOLFOX) or 5FU, FA, and Irinotecan (FOLFIRI) are standard regimens for palliative chemotherapy of metastatic colon cancer. Since data showing the influence of dose reduction in palliative treatment are rare, the objective of this single center, retrospective study was to further characterize the influence of dose reduction on efficacy of these therapeutic regimens. Methods: One hundred nine patients, diagnosed with stage IV colon cancer between 2004 and 2012 and receiving palliative first-line chemotherapy with either FOLFOX or FOLFIRI regimens in our outpatient clinic were analyzed for treatment efficacy. Patients who received dose reductions due to side effects usually received doses of 80% or lower of per protocol dose. Survival data were obtained from the Regensburg Tumor Registry. Survival analysis was performed using Kaplan-Meier statistical analysis and multivariable analysis. Results: A dose reduction due to side effects was necessary in 46 (42%) patients. Dose reduction was independent of age. Major reasons for dose reduction were neutropenia (30%) followed by polyneuropathy (16%) and diarrhea (14%). Dosage was more often reduced in patients receiving FOLFOX based therapy. Comparison of patients with dose reduction versus patients with full dosage showed no significant difference on overall survival (p = 0.430). Subgroup analysis revealed dose reduction in patients with N2 stage disease was associated with improved survival. Patients who underwent dose reduction received more cycles of chemotherapy (13.7 vs. 10.8 cycles) and cumulative dosage was similar in both groups. Conclusion: Contrary to our expectations, the need to reduce chemotherapy dosage due to side effects does not indicate a worse prognosis in our retrospective analysis. We believe this can in part be explained by better adaption to interindividual pharmacokinetics and longer time of treatment.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COLORECTAL-CANCER; ADJUVANT CHEMOTHERAPY; INTENSITY; OLDER; OPTIONS; TRIALS; Dose reduction; Cancer; Colorectal cancer; Chemotherapy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Chirurgie Medicine > Lehrstuhl für Innere Medizin I Medicine > Lehrstuhl für Innere Medizin III (Hämatologie und Internistische Onkologie) Medicine > Lehrstuhl für Pathologie Medicine > Lehrstuhl für Röntgendiagnostik Medicine > Zentren des Universitätsklinikums Regensburg > Tumorzentrum e.V. |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 20 Mar 2020 07:05 |
| Last Modified: | 20 Mar 2020 07:05 |
| URI: | https://pred.uni-regensburg.de/id/eprint/14711 |
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