Possibilities for reducing toxicity in colon cancer patients receiving adjuvant polychemotherapy

Abstract

Introduction. According to the World Health Organization, colorectal cancer is the third most common type of cancer in the world. The surgical method of treatment is the main one in locally advanced stages; however, a large proportion of patients require complex treatment, including adjuvant chemotherapy. When conducting adjuvant chemotherapy, it is extremely important to maintain the rhythm of cycles and minimize adverse events that may lead to dose reduction. Prevention of dose-limiting toxicity allows us to achieve the following goals – improving the quality of life of the patient and adherence to treatment, as well as performing a full-fledged stage of the planned complex treatment.Aim. Evaluation of the effectiveness of Polisorb MP in the occurrence of gastrointestinal side effects of adjuvant polychemotherapy in patients with colorectal cancer.Materials and methods. The prospective study included 40 patients with a verified diagnosis of CCR, received treatment and observation at the St. Petersburg City Clinical Oncology Centre from April 2022 to October 2022. All patients received radical surgery and subsequent adjuvant chemotherapy in the XELOX regimen were divided into two groups. The first group of patients (n = 20) received only ACT, patients of group 2 from 16 to 20 days after the completion of each session of ACT received Polysorb MP. Both groups were comparable in terms of gender and age. In the studied cohort of patients there were 20 (50.0 %) men and 20 (50.0 %) women. The age of patients ranged from 31 to 75 years; the median age was 62 years [54.00–68.50]. The quality of life of patients receiving adjuvant polychemotherapy was assessed using the QLQ-C30 questionnaires with the QLQ-CR29, EQ-5D module.Results. The use of Polysorb MP made it possible to significantly reduce the level of creatinine in the blood of patients, which can increase after one cycle of ACT, especially with the use of platinum preparations. In addition, our results indicate that the use of Polysorb MP after ACT in patients with colorectal cancer can significantly improve the quality of life of patients, both by minimizing the symptoms associated with previous treatment and the adverse effects of the drug treatment itself, as well as by improving the general condition of the patient. In patients who received Polysorb MP as an accompanying therapy against the background of AHT, significant deterioration in general and functional health (according to the results of the analysis of the QLQ-C30 questionnaires), increased severity of disease symptoms and treatment complications (according to the results of the analysis of the QLQ-C29 and QLQ-C30 questionnaires), as well as a significant decrease in the general state of health according to the results of the analysis of the dynamics on the EQ-5D scale, was not detected.Conclusions. In patients receiving adjuvant polychemotherapy for locally advanced colon cancer, it can be concluded that it is advisable to use Polysorb MP in order to reduce the manifestation of gastrointestinal toxicity and improve the quality of life of patients, which, in turn, allows a full course of treatment, avoiding dose-limiting adverse events.