Real-world adjuvant chemotherapy treatment patterns and outcomes over time for resected stage II and III colorectal cancer.
Asia Pac J Clin Oncol
; 19(3): 392-402, 2023 Jun.
Article
em En
| MEDLINE
| ID: mdl-36464923
ABSTRACT
BACKGROUND:
The administration of adjuvant chemotherapy (AC) to colorectal cancer (CRC) patients in Australia and impact of recent trial data has not been well reported. We aim to evaluate temporal trends in AC treatment and outcomes in real-world Australian patients.METHODS:
CRC patients were analyzed from 13 hospitals, stratified by stage (II or III) and three 5-year time periods (A 2005-2009, B 2010-2014, C 2015-2019). Stage III was further stratified as pre- and post publication of the International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration (March 2018). AC prescription, time-to-recurrence (TTR), and overall survival (OS) was compared across the time periods.RESULTS:
Of 3977 identified patients, 1148 (stage II 640, stage III 508), 1525 (856 vs. 669), and 1304 (669 vs. 635) were diagnosed in Period A, B, and C, respectively. Fewer patients in Period C received AC compared to Period B in stage II (10% vs. 15%, p <.01) and III (70% vs. 79%, p <.01). Post-IDEA, the proportion of patients receiving ≤3 months of oxaliplatin-based AC increased (45% vs. 13%, p <.01). The proportion of patients who remained recurrence free at 3 years was similar between time periods in stage II (A 89% vs. B 88% vs. C 90%, p = .53) and stage III (72% vs. 76% vs. 72%, p = .08). OS significantly improved for stage II (80%-85%, p = .04) and stage III (69%-77%, <.01) from period A to B.CONCLUSION:
AC use has moderately decreased over time with no impact on recurrence rates. Improved survival in more recent years despite similar recurrence rates may be related to improved baseline staging, better postrecurrence treatment, and reduced noncancer-related mortality.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
/
Fluoruracila
Limite:
Humans
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Asia Pac J Clin Oncol
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Austrália