Background:A fixed 8-cycle oxaliplatin and capecitabine(XELOX)regimen has been the standard adjuvant therapy for patients with stage III colon cancer.However,completing the full-cycle of oxaliplatin is often associate...Background:A fixed 8-cycle oxaliplatin and capecitabine(XELOX)regimen has been the standard adjuvant therapy for patients with stage III colon cancer.However,completing the full-cycle of oxaliplatin is often associated with severe neurotoxicity.To spare patients from the toxic effects,without comprising the required efficacy,we evaluated the safety and efficacy of a modified XELOX(mXELOX)adjuvant chemotherapy regimen with 6 cycles of oxaliplatin and a full cycle of capecitabine.Methods:We retrospectively analyzed 330 eligible patients with stage III colon cancer who underwent cura-tive tumor resection followed by mXELOX,standard XELOX or unfinished XELOX adjuvant chemotherapy between December 2007 and April 2015.Associated prognostic factors were investigated and their disease-free survival(DFS)and overall survival(OS)rates were also determined and compared among the different regimen groups.Results:Compared with the standard XELOX group,the mXELOX group had lower total incidence rates of neuro-toxicity(39.3%vs.76.2%,P<0.001),leucopenia(53.6%vs.69.8%,P=0.017)and thrombocytopenia(38.1%vs.56.3%,P=0.011).The standard XELOX and mXELOX adjuvant chemotherapy regimens presented with comparable 3-year DFS rates(86.3%vs.89.2%;P=0.838)and 3-year OS rates(92.7%vs.97.6%;P=0.227).Compared to unfinished XELOX chemotherapy,the oncologic benefits of the mXELOX regimen were greater for patients with T4 tumors(3-year DFS:Hazard ratio[HR],2.184;95%confidence interval[CI],1.051-4.540;P=0.036;3-year OS:HR,4.529;95%CI 1.245-16.479;P=0.022)and for high-risk patients(3-year DFS:HR,1.962;95%CI 0.964-3.993;P=0.044;3-year OS:HR,4.193;95%CI 1.182-14.874;P=0.026).Conclusions:The mXELOX adjuvant chemotherapy presented a comparable survival benefit and lower incidence of toxicity than standard XELOX chemotherapy.It could be an alternative treatment for high-risk patients with operated stage III colon cancer.展开更多
基金This work was funded by grants from National Natural Science Foundation of China(Grant No.81772595)Sun Yat-sen University Clinical Research 5010 Program(2015024)+1 种基金Sun Yat-sen University Clinical Research 5010 Program(2013013)Guangzhou Science and Technology Plan Projects(Health Medical Collaborative Innovation Program of Guangzhou)(Grant No.201803040019)
文摘Background:A fixed 8-cycle oxaliplatin and capecitabine(XELOX)regimen has been the standard adjuvant therapy for patients with stage III colon cancer.However,completing the full-cycle of oxaliplatin is often associated with severe neurotoxicity.To spare patients from the toxic effects,without comprising the required efficacy,we evaluated the safety and efficacy of a modified XELOX(mXELOX)adjuvant chemotherapy regimen with 6 cycles of oxaliplatin and a full cycle of capecitabine.Methods:We retrospectively analyzed 330 eligible patients with stage III colon cancer who underwent cura-tive tumor resection followed by mXELOX,standard XELOX or unfinished XELOX adjuvant chemotherapy between December 2007 and April 2015.Associated prognostic factors were investigated and their disease-free survival(DFS)and overall survival(OS)rates were also determined and compared among the different regimen groups.Results:Compared with the standard XELOX group,the mXELOX group had lower total incidence rates of neuro-toxicity(39.3%vs.76.2%,P<0.001),leucopenia(53.6%vs.69.8%,P=0.017)and thrombocytopenia(38.1%vs.56.3%,P=0.011).The standard XELOX and mXELOX adjuvant chemotherapy regimens presented with comparable 3-year DFS rates(86.3%vs.89.2%;P=0.838)and 3-year OS rates(92.7%vs.97.6%;P=0.227).Compared to unfinished XELOX chemotherapy,the oncologic benefits of the mXELOX regimen were greater for patients with T4 tumors(3-year DFS:Hazard ratio[HR],2.184;95%confidence interval[CI],1.051-4.540;P=0.036;3-year OS:HR,4.529;95%CI 1.245-16.479;P=0.022)and for high-risk patients(3-year DFS:HR,1.962;95%CI 0.964-3.993;P=0.044;3-year OS:HR,4.193;95%CI 1.182-14.874;P=0.026).Conclusions:The mXELOX adjuvant chemotherapy presented a comparable survival benefit and lower incidence of toxicity than standard XELOX chemotherapy.It could be an alternative treatment for high-risk patients with operated stage III colon cancer.
