The survival impact of palliative chemotherapy dose modifications on metastatic colon cancer
Abstract Background An uninterrupted dose of oxaliplatin-based cytotoxic therapy is an essential component in the standard treatment regimen of metastatic colon cancer (mCC). Data on the impacts of dose intensity reduction on the palliative treatment for patients with mCC remain scarce. Hence, this...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-022-09831-7 |
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| author | Mohd Naqib Zainal Abidin Marhanis Salihah Omar Farida Islahudin Noraida Mohamed Shah |
| author_facet | Mohd Naqib Zainal Abidin Marhanis Salihah Omar Farida Islahudin Noraida Mohamed Shah |
| author_sort | Mohd Naqib Zainal Abidin |
| collection | DOAJ |
| description | Abstract Background An uninterrupted dose of oxaliplatin-based cytotoxic therapy is an essential component in the standard treatment regimen of metastatic colon cancer (mCC). Data on the impacts of dose intensity reduction on the palliative treatment for patients with mCC remain scarce. Hence, this study aimed to investigate the impact of palliative chemotherapy dose modifications (DM) on the survival of patients with mCC. Methods Patients with stage IV colon cancer who received first-line palliative FOLFOX regimen chemotherapy between 2014 until 2018 in the Oncology Department of the National Cancer Institute were conveniently sampled retrospectively to analyse the treatment efficacy. The cumulative dose and duration of chemotherapy received by the patients were summarised as relative dose intensity (RDI) and stratified as High RDI (RDI ≥ 70%) or Low RDI (RDI < 70%). Progression-free survival (PFS) and 2-year overall survival (OS) between the two groups were analysed using Kaplan-Meier survival analysis and Cox proportional hazards models. Results Out of the 414 patients identified, 95 patients with mCC were eligible and included in the final analysis. About half of the patients (n = 47) completed the 12-cycle chemotherapy regimen and one patient received the complete (100%) RDI. The overall median RDI was 68.7%. The Low RDI group (n = 49) had a 1.5 times higher mortality risk than the High RDI group [OS, Hazard Ratio (HR) = 1.5, 95% Cl: 1.19–1.82] with a significant median OS difference (9.1 vs. 16.0 months, p < 0.01). Furthermore, patients with lower dose intensity showed double the risk of disease progression (PFS, HR = 2.0, 95% CI: 1.23–3.13) with a significant difference of 4.5 months of median PFS (p < 0.01). Gender and RDI were the independent prognostic factors of both OS and PFS. Conclusion Reduction in the dose intensity of palliative chemotherapy may adversely affect both disease progression and overall survival among mCC patients. |
| first_indexed | 2024-12-10T16:52:17Z |
| format | Article |
| id | doaj.art-5debad734b684ddea71c44161c34c2da |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-10T16:52:17Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-5debad734b684ddea71c44161c34c2da2022-12-22T01:40:51ZengBMCBMC Cancer1471-24072022-07-0122111110.1186/s12885-022-09831-7The survival impact of palliative chemotherapy dose modifications on metastatic colon cancerMohd Naqib Zainal Abidin0Marhanis Salihah Omar1Farida Islahudin2Noraida Mohamed Shah3Centre of Quality Management of Medicines, Faculty of Pharmacy, Universiti KebangsaanCentre of Quality Management of Medicines, Faculty of Pharmacy, Universiti KebangsaanCentre of Quality Management of Medicines, Faculty of Pharmacy, Universiti KebangsaanCentre of Quality Management of Medicines, Faculty of Pharmacy, Universiti KebangsaanAbstract Background An uninterrupted dose of oxaliplatin-based cytotoxic therapy is an essential component in the standard treatment regimen of metastatic colon cancer (mCC). Data on the impacts of dose intensity reduction on the palliative treatment for patients with mCC remain scarce. Hence, this study aimed to investigate the impact of palliative chemotherapy dose modifications (DM) on the survival of patients with mCC. Methods Patients with stage IV colon cancer who received first-line palliative FOLFOX regimen chemotherapy between 2014 until 2018 in the Oncology Department of the National Cancer Institute were conveniently sampled retrospectively to analyse the treatment efficacy. The cumulative dose and duration of chemotherapy received by the patients were summarised as relative dose intensity (RDI) and stratified as High RDI (RDI ≥ 70%) or Low RDI (RDI < 70%). Progression-free survival (PFS) and 2-year overall survival (OS) between the two groups were analysed using Kaplan-Meier survival analysis and Cox proportional hazards models. Results Out of the 414 patients identified, 95 patients with mCC were eligible and included in the final analysis. About half of the patients (n = 47) completed the 12-cycle chemotherapy regimen and one patient received the complete (100%) RDI. The overall median RDI was 68.7%. The Low RDI group (n = 49) had a 1.5 times higher mortality risk than the High RDI group [OS, Hazard Ratio (HR) = 1.5, 95% Cl: 1.19–1.82] with a significant median OS difference (9.1 vs. 16.0 months, p < 0.01). Furthermore, patients with lower dose intensity showed double the risk of disease progression (PFS, HR = 2.0, 95% CI: 1.23–3.13) with a significant difference of 4.5 months of median PFS (p < 0.01). Gender and RDI were the independent prognostic factors of both OS and PFS. Conclusion Reduction in the dose intensity of palliative chemotherapy may adversely affect both disease progression and overall survival among mCC patients.https://doi.org/10.1186/s12885-022-09831-7Relative dose intensityDose reductionDose delaysDose modificationsMetastatic colorectal CancerPalliative chemotherapy |
| spellingShingle | Mohd Naqib Zainal Abidin Marhanis Salihah Omar Farida Islahudin Noraida Mohamed Shah The survival impact of palliative chemotherapy dose modifications on metastatic colon cancer BMC Cancer Relative dose intensity Dose reduction Dose delays Dose modifications Metastatic colorectal Cancer Palliative chemotherapy |
| title | The survival impact of palliative chemotherapy dose modifications on metastatic colon cancer |
| title_full | The survival impact of palliative chemotherapy dose modifications on metastatic colon cancer |
| title_fullStr | The survival impact of palliative chemotherapy dose modifications on metastatic colon cancer |
| title_full_unstemmed | The survival impact of palliative chemotherapy dose modifications on metastatic colon cancer |
| title_short | The survival impact of palliative chemotherapy dose modifications on metastatic colon cancer |
| title_sort | survival impact of palliative chemotherapy dose modifications on metastatic colon cancer |
| topic | Relative dose intensity Dose reduction Dose delays Dose modifications Metastatic colorectal Cancer Palliative chemotherapy |
| url | https://doi.org/10.1186/s12885-022-09831-7 |
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