Effectiveness of capecitabine plus oxaliplatin for advanced colon cancer: A public hospital experience.

Abstract

570 Background: Adjuvant chemotherapy has been shown to improve disease-free survival (DFS) and overall survival (OS) in advanced colon cancer (CC). 5-fluorouracil (5-FU)/leucovorin and oxaliplatin is the first line therapy for stage II and III CC. Due to systematic and financial constraints imposed by administering infusional 5-FU, this agent is not available at our institution. Capecitabine plus oxaliplatin (CAPOX) has been studied by others as a possible alternative. We report our experience with CAPOX in the adjuvant treatment of CC patients in a large, public hospital. Methods: A retrospective study of 142 patients with CC who received CAPOX from 2005 to 2011 was performed. Data on patient demographics, treatment, disease recurrence, and survival were analyzed. Survival was assessed by the Kaplan-Meier method. The Cox regression model was used for multivariate analysis. Results: There were 60 female and 82 male patients with a mean age of 54 years (range 21-80). 57 patients were diagnosed with stage II CC and 85 with stage III CC. All patients with stage II and stage III disease underwent curative-intent surgical resection, except for one patient, who refused surgery. 14/141 operations (10%) were performed emergently. Mean follow-up was 36 months (range 2-85 months). The 3-year OS rates were 91% and 81% for stages II and III, respectively. The 3-year DFS rate was 74% for stage II and 66% for stage III. By multivariate analysis, only cancer stage was predictive of overall survival. Conclusions: CAPOX is an effective treatment for stage II and III CC in the adjuvant setting. Our study supports recent evidence demonstrating the efficacy of CAPOX in CC. Ease of administration and improved utilization of resources make it an ideal regimen for public hospital facilities.