Modified Folfox6 as Adjuvant Chemotherapy in Vietnamese Patients With Colorectal Cancer

T Quang Nguyen, T Oanh Bui, P Thao Tran, V Thuan Tran, V Hieu Nguyen, Q Hoan Chu, T A Tuyet Bui, N Quynh Le, V Quang Le, V Tu Dao, T Quang Nguyen, T Oanh Bui, P Thao Tran, V Thuan Tran, V Hieu Nguyen, Q Hoan Chu, T A Tuyet Bui, N Quynh Le, V Quang Le, V Tu Dao

Abstract

Colorectal cancer is the third most common cancer and the second leading cause of death from cancer worldwide. In Vietnam, the disease is the fifth leading cancer (8.9%), with 14 733 new cases in 2018. In recent years, the mFolfox6 regimen has been indicated commonly as the adjuvant chemotherapy after curative resection for patients with colorectal cancer. However, the efficacy of the regimen in Vietnamese patients has not been assessed and reported. In this retrospective study, we reviewed medical records of 83 patients with stage II or stage III colorectal cancer who received mFOLFOX6 regimen in order to investigate simultaneously survival and safety of this chemotherapy regimen. Three-year overall and disease-free survival were 84.3% and 79.5%, respectively. Our data revealed that postoperative Carcinoma Embryonic Antigen (CEA) level was a significant prognostic factor for survival, with hazard ratio of 3.83 and 3.67, respectively (P < .05), for overall survival and disease-free survival in the elevated CEA level group when compared to the normal CEA level group. The regimen also demonstrated to be well tolerated and can be used in routine practice as an adjuvant chemotherapy.

Keywords: adjuvant chemotherapy; colorectal cancer; mFOLFOX 6 regime; overall survival.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Kaplan-Meier estimates of overall survival (OS) and disease-free survival (DFS).
Figure 2.
Figure 2.
Kaplan-Meier estimates of overall survival (OS) and disease-free survival (DFS), according to Carcinoma Embryonic Antigen (CEA) levels after curative surgery.
Figure 3.
Figure 3.
Kaplan-Meier estimates of overall survival (OS) and disease-free survival (DFS), according to stages of cancer.

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.
    1. Pectasides D, Karavasilis V, Papaxoinis G, et al. Randomized phase III clinical trial comparing the combination of capecitabine and oxaliplatin (CAPOX) with the combination of 5-fluorouracil, leucovorin and oxaliplatin (modified FOLFOX6) as adjuvant therapy in patients with operated high-risk stage II or stage III colorectal cancer. BMC Cancer. 2015;15:384.
    1. André T, Boni C, Navarro M, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol. 2009;27(19):3109–3116.
    1. Vincent TD. Colon Cancer, Principles & Practice of Oncology. 8th ed Philadelphia, PA: Lippincott Williams & Wilkins; 2008.
    1. André T, Boni C, Mounedji-Boudiaf L, et al. Oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment for colon cancer. N Engl J Med. 2004;350(23):2343–2351.
    1. Sargent DJ. Effect of oxaliplatin, fluorouracil, and leucovorin with or without cetuximab on survival among patients with resected stage III colon cancer: a randomized trial. JAMA. 2012;307(13):1383–1393.
    1. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology. Colon Cancer. Version 4.2018. National Comprehensive Cancer Network (NCCN); 2018.
    1. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology. Rectal Cancer. Version 3.2018. National Comprehensive Cancer Network (NCCN); 2018.
    1. Jeon HJ, Woo JH, Lee HY, Park KJ, Choi HJ. Adjuvant chemotherapy using the FOLFOX regimen in colon cancer. J Korean Soc Coloproctology. 2011;27(3):140–146.
    1. Allegra CJ, Yothers G, O’Connell MJ, et al. Phase III trial assessing bevacizumab in stages II and III carcinoma of the colon: results of NSABP protocol C-08. J Clin Oncol. 2011;29(1):11–16.
    1. Gramont A, Van Cutsem E, Schmoll HJ, et al. Bevacizumab plus oxaliplatin-based chemotherapy as adjuvant treatment for colon cancer (AVANT): a phase 3 randomised controlled trial. Lancet Oncol. 2012;13(12):1225–1233.
    1. Wang JY, Lu CY, Chu KS, et al. Prognostic significance of pre- and postoperative serum carcinoembryonic antigen levels in patients with colorectal cancer. Eur Surg Res. 2007;39(4):245–250.
    1. Lin JK, Lin CC, Yang SH, et al. Early postoperative CEA level is a better prognostic indicator than is preoperative CEA level in predicting prognosis of patients with curable colorectal cancer. Int J Colorectal Dis. 2011;26(9):1135–1141.
    1. Kosugi C, Koda K, Ishibashi K, et al. Safety of mFOLFOX6/XELOX as adjuvant chemotherapy after curative resection of stage III colon cancer: phase II clinical study (The FACOS study). Int J Colorectal Dis. 2018;33(6):809–817.
    1. Goldberg RM, Sargent DJ, Thibodeau SN, et al. Adjuvant mFOLFOX6 plus or minus cetuximab (Cmab) in patients (pts) with KRAS mutant (m) resected stage III colon cancer (CC): NCCTG Intergroup Phase III Trial N0147. J Clin Oncol. 2010;28(suppl 15):3508–3508.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다