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Impact of dose-capping chemotherapy in concurrent chemoradiotherapy in rectal cancer patients.
Yang, Ran; Younis, Moftah; Joseph, Kurian; Ghosh, Sunita; Nijjar, Tirath; Severin, Diane; Tankel, Keith; Tamhane, Yash; Fairchild, Alysa; Spratlin, Jennifer; Mulder, Karen; Usmani, Nawaid.
Afiliação
  • Yang R; Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
  • Younis M; Division of Radiation Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
  • Joseph K; Division of Radiation Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
  • Ghosh S; Division of Medical Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
  • Nijjar T; Division of Radiation Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
  • Severin D; Division of Radiation Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
  • Tankel K; Division of Radiation Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
  • Tamhane Y; Division of Radiation Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
  • Fairchild A; Division of Radiation Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
  • Spratlin J; Division of Medical Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
  • Mulder K; Division of Medical Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
  • Usmani N; Division of Radiation Oncology, Faculty of Medicine and Dentistry, University of Alberta and Cross Cancer Institute, Edmonton, AB, Canada.
J Oncol Pharm Pract ; 27(7): 1596-1603, 2021 Oct.
Article em En | MEDLINE | ID: mdl-33023385
INTRODUCTION: The study evaluated the effect of chemotherapy dose-capping on disease recurrence, toxicity and survival of rectal cancer patients treated with chemoradiotherapy (CRT). METHODS: 601 consecutive rectal cancer patients treated with concurrent CRT were retrospectively analysed. Dose-capped patients were defined as having a body surface area (BSA) ≥2.0 m2 and who received <95% full weight-based chemotherapy dose. Binary logistic regression was used to study the factors associated with the outcome variables (capped vs. uncapped). Kaplan-Meier estimation evaluated significant predictors of survival. RESULTS: The median follow-up time was 7.54 years. The rate of disease recurrence was significantly higher in dose-capped patients (35%) compared to those without dose-capping (24%, P = 0.016). The adjusted odds ratio for dose-capped patients experiencing recurrence was 1.64 compared to uncapped patients (95% CI, 1.10-2.43). Overall, dose-capped patients were less likely to experience significant toxicity requiring dose reduction and/or treatment break when compared to uncapped patients (15% and 28% respectively, P = 0.008).There was significant differences in PFS between capped and uncapped group (77% vs. 85%; P = 0.017). The 5-year OS in the capped group was 75.0%, and 80% in the uncapped group (P = 0.149). CONCLUSIONS: Rectal cancer patients treated with dose-capped CRT were at increased risk of disease recurrence. Patients dosed by actual BSA did experience excessive toxicity compared to dose-capped group. We recommend that chemotherapy dose-capping based on BSA should not be practiced in rectal cancer patients undergoing CRT.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Protocolos de Quimioterapia Combinada Antineoplásica Tipo de estudo: Observational_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Retais / Protocolos de Quimioterapia Combinada Antineoplásica Tipo de estudo: Observational_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article