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Vol 66, No 4 (2016)
Research paper (original)
Published online: 2016-12-23
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Chemotherapy for advanced colorectal patients: daily practice results may not reflect the outcomes of prospective clinical trials

Krzysztof Adamowicz, Jacek Jassem
·
Nowotwory. Journal of Oncology 2016;66(4):285-292.

open access

Vol 66, No 4 (2016)
Original article
Published online: 2016-12-23

Abstract

Introduction. Colorectal cancer is the second cause of cancer deaths worldwide. The development of new drugs in recent years has improved the outcomes, but it is not clear whether this progress also includes patients managed in daily clinical practice. Treatment outcomes in patients with advanced colorectal cancer treated in Poland outside of clinical trials are scare.

Methods. We analyzed the results of first-line chemotherapy in 165 patients with advanced colorectal cancer treated between May 2010 and December 2013 in two institutions.

Results. The mean patient age was 61 ± 8.7 years; 105 patients received irinotecan-based regimens (CLF1 or XELIRI), 41 oxaliplatin-based regimens (FOLFOX4 or XELOX) and 19 patients received single-agent 5-fluorouracil. A partial response was achieved in 48 patients (29%), stable disease in 71 (43%) and 46 patients (28%) progressed during treatment. Median survival in the entre group was 14 months. Respective average response rate and median overall survival in recent clinical trials were 39% and 17 months, respectively. Compared to single agent treatment, multidrug chemotherapy was associated with increased general toxicity (p = 0.039), in particular with higher occurrence of diarrhea (p = 0.003) and peripheral neuropathy (p < 0.001). There was no apparent impact of chemotherapy on overall quality of life.

Conclusions. Treatment results of advanced colorectal cancer in daily practice may be worse than those obtained in prospective clinical trials. The use of palliative chemotherapy has no noticeable impact on quality of life.

Abstract

Introduction. Colorectal cancer is the second cause of cancer deaths worldwide. The development of new drugs in recent years has improved the outcomes, but it is not clear whether this progress also includes patients managed in daily clinical practice. Treatment outcomes in patients with advanced colorectal cancer treated in Poland outside of clinical trials are scare.

Methods. We analyzed the results of first-line chemotherapy in 165 patients with advanced colorectal cancer treated between May 2010 and December 2013 in two institutions.

Results. The mean patient age was 61 ± 8.7 years; 105 patients received irinotecan-based regimens (CLF1 or XELIRI), 41 oxaliplatin-based regimens (FOLFOX4 or XELOX) and 19 patients received single-agent 5-fluorouracil. A partial response was achieved in 48 patients (29%), stable disease in 71 (43%) and 46 patients (28%) progressed during treatment. Median survival in the entre group was 14 months. Respective average response rate and median overall survival in recent clinical trials were 39% and 17 months, respectively. Compared to single agent treatment, multidrug chemotherapy was associated with increased general toxicity (p = 0.039), in particular with higher occurrence of diarrhea (p = 0.003) and peripheral neuropathy (p < 0.001). There was no apparent impact of chemotherapy on overall quality of life.

Conclusions. Treatment results of advanced colorectal cancer in daily practice may be worse than those obtained in prospective clinical trials. The use of palliative chemotherapy has no noticeable impact on quality of life.

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Keywords

colorectal cancer, chemotherapy, treatment outcomes

About this article
Title

Chemotherapy for advanced colorectal patients: daily practice results may not reflect the outcomes of prospective clinical trials

Journal

Nowotwory. Journal of Oncology

Issue

Vol 66, No 4 (2016)

Article type

Research paper (original)

Pages

285-292

Published online

2016-12-23

Page views

669

Article views/downloads

1324

DOI

10.5603/NJO.2016.0055

Bibliographic record

Nowotwory. Journal of Oncology 2016;66(4):285-292.

Keywords

colorectal cancer
chemotherapy
treatment outcomes

Authors

Krzysztof Adamowicz
Jacek Jassem

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