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2015 ; 10
(9
): e0138632
Nephropedia Template TP
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English Wikipedia
Stage III Colon Cancer: The Individualized Strategy of Adjuvant Chemotherapy for
Aged Under and Over 70
#MMPMID26382962
Lu CS
; Chang PY
; Chen YG
; Chen JH
; Wu YY
; Ho CL
PLoS One
2015[]; 10
(9
): e0138632
PMID26382962
show ga
BACKGROUND: The aim of this study was to examine the specific chemoregimens
selected for adjuvant therapy in the patients with stage III colon cancer. We
investigated the trends in chemotherapeutic prescribing patterns and looked for
adequate therapeutic setting for these patients. METHODS: 288 patients presenting
with stage III colon cancer and undergoing adjuvant therapies after curative
surgery for more than 3-month were enrolled between January 2006 and December
2011. Demographic characteristics and therapeutic factors were analyzed,
including age, gender, histological grade, tumor sizes, tumor location,
pathologic stage, performance status, serum carcinoembryonic antigen, regimens
selection, interval from the operation to the start of adjuvant therapy and
prolonged adjuvant therapy. Kaplan- Meier methods were utilized for drawing
survival curves and Cox model was used to analyze survival, prognostic factors.
RESULTS: The analysis showed that the patients aged under 70 received more
intensive therapies than those aged over 70 (P<0.001). Later, advanced analysis
in therapeutic factors was conducted between the patients aged under 70 and those
over 70. In the patients aged under 70, significant differences in 4-year overall
survival (OS) were noted between UFUR (oral tegafur-uracil plus leucovorin)
groups and FOLFOX (5-FU plus oxaliplatin) [65.6% versus (vs) 89.8%, relative risk
(RR) 3.780, 95% confidence interval (CI) 1.263-11.315, P = 0.017]. There were
also differences in 4-year OS between these patients with and without
oxaliplatin-contained regimens (92.1% vs 83.4%, respectively, RR 0.385, 95% CI
0.157-0.946, P = 0.037). In addition, the patients who received intravenous or
combined therapy also had higher 4-year OS than those only received oral regimens
(92.1% vs 76.6%, P = 0.077), though the finding did not reach statistical
significance. In contrast to the survival benefits of above therapeutic settings
for the patients aged under 70, there was less advantage in the old patients when
they received intensive therapies or even oxaliplatin-contained regimens.
Prolonged cycles of adjuvant therapy resulted in no significant benefit to
survival rates regardless of ages. CONCLUSIONS: The adequate individualized
therapeutic strategy plays an important role for stage III colon cancer. Our
findings suggested that benefit of oxaliplatin-contained therapy is limited to
patients aged under 70 and oral fluoropyrimidines may be an effective option for
old patients. In addition, prolonged adjuvant setting is suggested to be
unbeneficial for managing stage III colon cancer.
|Adult
[MESH]
|Age Factors
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
[MESH]