Abstract
Background: Colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of cancer-related deaths in the world. The treatment of stage III CRC consists of surgery followed by adjuvant chemotherapy with either single agent capecitabine or combination therapy consisting of FOLFOX or XELOX, all of which have been shown to be effective in improving disease-free survival (DFS) and overall survival (OS). However, toxicities acquired from chemotherapy can affect a cancer patient’s quality of life and result in early treatment discontinuation. Common toxicities include hematological, gastrointestinal (GI), constitutional, dermatological, and neurological. Aim of the Work: The present work was aimed to assess and evaluate chemotherapy toxicities in adjuvant treatment in CRC patients and analyze certain factors that might increase chemotherapy toxicity. Patients and Methods: This is retrospective study included a total of 72 patients of colorectal carcinoma received adjuvant chemotherapy at Clinical Oncology Department, Ain Shams University. The study was conducted between Jan. 2012 and Jan. 2017. Results: We found that the most chemotherapy reported was neurological toxicity in (73.6%), gastrointestinal symptoms (diarrhea 52.7%, nausea 30.6%, vomiting 27.8% & oral mucositis 24%), hematological toxicity (neutropenia 40.3%, anemia 34.7%, thrombocytopenia 12.5%), fatigue 20.9%, hepatic toxicity 18.1%, dermatological toxicity 9.7% & renal toxicity 5.6%). older patients have significant incidence of neurological toxicity (p-value = 0.023) and fatigue (p-value = 0.038). females have significant incidence of anemia (p-value = 0.017). increase of oxaliplatin cumulative dose increase incidence of neurological toxicity (p-value = 0.024), thrombocytopenia (p-value = 0.007) and renal toxicity (p-value = 0.030). Oxaliplatin containing regimens have high significant correlation with neurological toxicity (p-value = 0.000) and capcitabine has high significant correlation with dermatological toxicity (p-value = 0.000). Conclusion: The most overall toxicity reported during adjuvant treatment in CRC was neurological toxicity. Although a variety of adverse reactions were reported the treatment regimens were tolerated but we should take care of factors that may increase certain toxicity.
Highlights
Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States [1]
The most overall toxicity reported during adjuvant treatment in CRC was neurological toxicity
This was a retrospective where data obtained from medical records of patients with colorectal cancer treated in adjuvant setting between Jan. 2012 and Jan. 2017 in Ain Shams University Oncology Department
Summary
Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the United States [1]. A significant proportion of stage III colon cancer patients who undergo potentially curative surgical resection develop disease recurrence secondary to clinically occult micro metastatic disease present at the time of surgery. For nearly 15 years, oxaliplatin-based chemotherapy for 6 months, with FOLFOX (folinic acid, fluorouracil [5-FU], oxaliplatin) or XELOX (capecitabine, oxaliplatin; called CAPOX), has been the standard adjuvant treatment for stage III colon cancer patients who have good performance status and are able to tolerate aggressive combination chemotherapy. Results: We found that the most chemotherapy reported was neurological toxicity in (73.6%), gastrointestinal symptoms (diarrhea 52.7%, nausea 30.6%, vomiting 27.8% & oral mucositis 24%), hematological toxicity (neutropenia 40.3%, anemia 34.7%, thrombocytopenia 12.5%), fatigue 20.9%, hepatic toxicity 18.1%, dermatological toxicity 9.7% & renal toxicity 5.6%). A variety of adverse reactions were reported the treat-
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