Adjuvant chemotherapy in stage II–III operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified CAPOX
Background: Data regarding the practice of adjuvant chemotherapy, specifically with modified CAPOX, and survival outcomes in operated colon cancer patients from a nontrial cohort in a lower-middle income and low prevalence nation like India is scarce. Materials and Methods: Patients who underwent up...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2019-01-01
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| Series: | South Asian Journal of Cancer |
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| Online Access: | http://journal.sajc.org/article.asp?issn=2278-330X;year=2019;volume=8;issue=3;spage=160;epage=165;aulast=Ramaswamy |
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| author | Anant Ramaswamy Rushabh Kothari Ashwin Desouza Tarachand Gupta Sandeep Bairwa Akhil Kapoor Amit Kumar Pradeep Ventrapati Mukta Ramadwar Sarika Mandavkar Nita Chavan Avanish Saklani Vikas Ostwal |
| author_facet | Anant Ramaswamy Rushabh Kothari Ashwin Desouza Tarachand Gupta Sandeep Bairwa Akhil Kapoor Amit Kumar Pradeep Ventrapati Mukta Ramadwar Sarika Mandavkar Nita Chavan Avanish Saklani Vikas Ostwal |
| author_sort | Anant Ramaswamy |
| collection | DOAJ |
| description | Background: Data regarding the practice of adjuvant chemotherapy, specifically with modified CAPOX, and survival outcomes in operated colon cancer patients from a nontrial cohort in a lower-middle income and low prevalence nation like India is scarce. Materials and Methods: Patients who underwent upfront curative resection for colon cancer from January 2013 to December 2016 were analyzed for baseline variables and outcomes. Results: A total of 491 patients underwent curative resection in the predefined time period. The median age of the patients was 53 years (range: 17–87). Patients with Stage I, Stage II, and Stage III disease comprised 7.9%, 44.8%, and 45.4% of the entire cohort, respectively. Patients with Stage I cancer were observed. Adjuvant chemotherapy was planned for 384 patients (78.2%), with the doublet regimens (capecitabine-oxaliplatin, or 5-fluorouracil-oxaliplatin) being used commonly (77.6%). Common toxicities were Hand-foot syndrome (Grade 2/3 - 21.4%) and peripheral neuropathy (Grade 2/3 - 20.1%). About 85% of patients receiving monotherapy (capecitabine or 5 fluorouracil) and 81.2% of patients receiving doublet chemotherapy (mCAPOX or modified FOLFOX-7) completed their planned adjuvant treatment. With a median follow-up of 22 months, estimated 3 years event-free survival was 86%, and overall survival (OS) was 93.6%. Stage, younger age (<50 years), underlying cardiovascular abnormalities, need for dose reductions and noncompletion of planned chemotherapy predicted for inferior estimated 3-year OS on multivariate analysis. Conclusions: Adjuvant chemotherapy especially with modified CAPOX appears well tolerated in the Indian population and early survival outcomes appear to be comparable to published literature. |
| first_indexed | 2024-12-16T06:27:44Z |
| format | Article |
| id | doaj.art-b9eb59c6697646619046f6edc2560c74 |
| institution | Directory Open Access Journal |
| issn | 2278-330X |
| language | English |
| last_indexed | 2024-12-16T06:27:44Z |
| publishDate | 2019-01-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | South Asian Journal of Cancer |
| spelling | doaj.art-b9eb59c6697646619046f6edc2560c742022-12-21T22:40:57ZengThieme Medical and Scientific Publishers Pvt. Ltd.South Asian Journal of Cancer2278-330X2019-01-018316016510.4103/sajc.sajc_176_18Adjuvant chemotherapy in stage II–III operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified CAPOXAnant RamaswamyRushabh KothariAshwin DesouzaTarachand GuptaSandeep BairwaAkhil KapoorAmit KumarPradeep VentrapatiMukta RamadwarSarika MandavkarNita ChavanAvanish SaklaniVikas OstwalBackground: Data regarding the practice of adjuvant chemotherapy, specifically with modified CAPOX, and survival outcomes in operated colon cancer patients from a nontrial cohort in a lower-middle income and low prevalence nation like India is scarce. Materials and Methods: Patients who underwent upfront curative resection for colon cancer from January 2013 to December 2016 were analyzed for baseline variables and outcomes. Results: A total of 491 patients underwent curative resection in the predefined time period. The median age of the patients was 53 years (range: 17–87). Patients with Stage I, Stage II, and Stage III disease comprised 7.9%, 44.8%, and 45.4% of the entire cohort, respectively. Patients with Stage I cancer were observed. Adjuvant chemotherapy was planned for 384 patients (78.2%), with the doublet regimens (capecitabine-oxaliplatin, or 5-fluorouracil-oxaliplatin) being used commonly (77.6%). Common toxicities were Hand-foot syndrome (Grade 2/3 - 21.4%) and peripheral neuropathy (Grade 2/3 - 20.1%). About 85% of patients receiving monotherapy (capecitabine or 5 fluorouracil) and 81.2% of patients receiving doublet chemotherapy (mCAPOX or modified FOLFOX-7) completed their planned adjuvant treatment. With a median follow-up of 22 months, estimated 3 years event-free survival was 86%, and overall survival (OS) was 93.6%. Stage, younger age (<50 years), underlying cardiovascular abnormalities, need for dose reductions and noncompletion of planned chemotherapy predicted for inferior estimated 3-year OS on multivariate analysis. Conclusions: Adjuvant chemotherapy especially with modified CAPOX appears well tolerated in the Indian population and early survival outcomes appear to be comparable to published literature.http://journal.sajc.org/article.asp?issn=2278-330X;year=2019;volume=8;issue=3;spage=160;epage=165;aulast=RamaswamyAdjuvant chemotherapyCAPOXcolon cancercomplianceIndia |
| spellingShingle | Anant Ramaswamy Rushabh Kothari Ashwin Desouza Tarachand Gupta Sandeep Bairwa Akhil Kapoor Amit Kumar Pradeep Ventrapati Mukta Ramadwar Sarika Mandavkar Nita Chavan Avanish Saklani Vikas Ostwal Adjuvant chemotherapy in stage II–III operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified CAPOX South Asian Journal of Cancer Adjuvant chemotherapy CAPOX colon cancer compliance India |
| title | Adjuvant chemotherapy in stage II–III operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified CAPOX |
| title_full | Adjuvant chemotherapy in stage II–III operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified CAPOX |
| title_fullStr | Adjuvant chemotherapy in stage II–III operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified CAPOX |
| title_full_unstemmed | Adjuvant chemotherapy in stage II–III operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified CAPOX |
| title_short | Adjuvant chemotherapy in stage II–III operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified CAPOX |
| title_sort | adjuvant chemotherapy in stage ii iii operated colon cancer patients from a nontrial cohort in a low colon cancer prevalence country with predominant use of modified capox |
| topic | Adjuvant chemotherapy CAPOX colon cancer compliance India |
| url | http://journal.sajc.org/article.asp?issn=2278-330X;year=2019;volume=8;issue=3;spage=160;epage=165;aulast=Ramaswamy |
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