Clinical comparison of QOL and adverse events during postoperative adjuvant chemotherapy in outpatients with node-positive colorectal cancer or gastric cancer

Abstract

Abstract. The aim of this study was to evaluate the quality of life (QOL) from the performance status (PS) and face scale (FS), and to compare adverse events (AEs) during chemotherapy in 28 patients with node-positive colorectal cancer (NP-CRC) and 15 patients with node-positive gastric cancer (NP-GC). The anticancer regimen consisted of 5-FU/ LV+CPT-11 for NP-CRC and 5-FU+low-dose CDDP for NP-GC. Results were evaluated after completion of three courses. QOL evaluation revealed no significant differences between the two groups with respect to PS and FS. Among hematological AEs, grade 1/2 mild leucopenia was significantly more common in NP-CRC than NP-GC patients (p<0.05), while grade 1/2 mild thrombocytopenia was significantly more common in NP-GC than NP-CRC patients (p<0.05). Among non-hematological AEs, grade 1/2 mild neuropathy (olfactory nerve) was significantly more common in NP-CRC than NP-GC patients (p<0.05). The monthly cost for one course was ~€586.8 for NP-CRC patients and ~€181.8 for NP-GC patients. These results suggest that first-line postoperative outpatient adjuvant chemotherapy for NP-CRC and NP-GC shows no significant differences with respect to QOL, but both AEs and the cost are higher for NP-CRC than for NP-GC.

Efficacy of 5-FU/LV plus CPT-11 as first-line adjuvant chemotherapy for stage IIIa colorectal cancer

“…Even with this regimen, however, the cumulative dosage exceeds 1,200 mg if a total of six courses are completed. With this regimen there were no serious adverse events (e.g., leucopenia or anemia) of grade 3 or 4 and the reported events were all grade 1 or 2, including mild leucopenia (approximately 42%), nausea/vomiting (approximately 50%), and neuropathy (abnormal sense of smell in approximately 25%) (20). The FLC regimen allows long-term treatment at moderate doses and is less likely to raise the problem of drop-outs due to adverse events.…”

“…In addition, post-recurrence second-line or subsequent therapy, including hepatic arterial infusion, radiofrequency ablation (RFA), and XRT, has not been standardized. This suggests that, under the present circumstances, 3Y-RFS and 5Y-RFS evaluate the control of early recurrence, better than 5Y-OS when assessing approximately 6 months of first-line adjuvant chemotherapy early in the postoperative course, although 5Y-OS is suitable for comparison among institutions (18)(19)(20). Colorectal cancer recurs in 60-70% of patients within approximately 2 years after surgery and in over 80% within approximately 3 years (2,3).…”

“…According to some reports, addition of CPT-11 or L-OHP to 5-FU/LV therapy has nearly equivalent of anticancer drug sensitivity. In the first-line setting following curative resection, CPT-11 is a more reasonable choice than L-OHP because of a low incidence of neurological adverse events such as neuropathy and paresthesia and because it is less costly (11,12,20). It would seem advisable to retain L-OHP as a second-line treatment for distant metastasis/recurrence.…”

“…The FLC group (n=54) received the modified Machover regimen plus intravenous CPT-11 [(60 mg/m 2 ) on days 1 and 15 every month x 5-6 courses], followed by the same oral UFT plus PSK therapy for 6 months or more as the FL group ( Fig. 1) (17,19,20).…”

The use of morphometric and fractal parameters to assess the effects of 5-fluorouracil, interferon and dexamethasone treatment on colonic anastomosis healing: an experimental study in rats

“…Patients operated upon due to advanced bowel inflammation need a follow-up comprising the administration of systemic steroids [1,2]. Both treatments have been found to have local and systemic adverse effects [3][4][5][6]. Since its introduction, 5-fluorouracil has been considered the gold standard therapy for colorectal cancer.…”