Prognostic factors and safety study of R0 resection colorectal cancer patients received capecitabine based adjuvant chemotherapy in real world

doi:10.12092/j.issn.1009-2501.2019.06.017

Abstract

Abstract:

AIM: To investigate the prognostic factors and safety of R0 resection colorectal cancer patients received capecitabine based adjuvant chemotherapy in real world. METHODS: From Jan 2010 to December 2017, a total of 279 CRC patients underwent R0 surgical resection and received capecitabine based adjuvant chemotherapy were included in this study. Baseline characteristics data were collected through the hospital case system. The early follow-up was done during the fixed period of adjuvant chemotherapy in the hospital. Subsequent follow-up of the prognosis was telephone follow-up every three months. Disease-free survival (DFS) and overall survival (OS) were analyzed by Kaplan-Meier survival analysis. Adverse reactions were evaluated according to CTCAE 4.0. Adverse reactions above grade 2 were recorded. RESULTS:The median age of the 279 patients included in the study was 51, ranging from 19-82.167 cases (59.86%) were male. 180 patients (64.52%) were ECOG 0.173 cases of colon cancer and 106 cases of rectal cancer were included. In terms of tumor differentiation, 58 patients had well differentiation, 192 patients had intermediate differentiation, and 17 patients had poor differentiation. 58 cases of stage II patients and 221 cases of stage III patients were involved. In the state of mismatched repair gene (MMR), 19 patients with mismatched repair gene deletion (dMMR), 176 patients with mismatched repair gene presence (pMMR), and 84 patients was no detection. There were 73 patients with T1-2 and 206 patients with T3-4. 71 patients received capecitabine monotherapy and 208 patients received capecitabine combined with oxaliplatin adjuvant chemotherapy. All of the 279 CRC patients were of available for prognosis evaluation. The median disease-free survival (DFS) of the 265 CRC patients were 4.7 years (95%CI: 4.12-5.33), the median overall survival (OS) were 6.6 years (95%CI: 5.74-7.27). Adjusted in multivariate Cox regression analysis for OS, ECOG score and pathological staging were independent factors for OS. In terms of adverse reactions, neutropenia, hand and foot syndrome, diarrhea and other adverse reactions with a higher incidence of grade 2 or above were found. Overall adverse events were manageable and controllable. CONCLUSION:Capecitabine-based adjuvant chemotherapy has superior prognosis and safety in patients with colorectal cancer after R0 resection.

Key words: colorectal cancer, adjuvant chemotherapy, capecitabine, prognosis

CLC Number:

R735.3

LI Rongzhen, MEI Jiazhuan, XIA Yunzhan, JI Jie. Prognostic factors and safety study of R0 resection colorectal cancer patients received capecitabine based adjuvant chemotherapy in real world[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(6): 704-711.

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