[Show abstract][Hide abstract] ABSTRACT: Several oxaliplatin-specific scales have been proposed in clinical practice to evaluate oxaliplatin-related neurotoxicity. We investigated whether there might be a discrepancy between the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) and the Neurotoxicity Criteria of Debiopharm (DEB-NTC), the commonly used oxaliplatin-specific scales, in the evaluation of peripheral neurotoxicity.
The subjects were 42 patients with metastatic colorectal cancer who received more than 6 cycles of first-line therapy with modified FOLFOX6 and more than 6 cycles of second-line therapy with FOLFIRI. The median number and cumulative dose of oxaliplatin administrations were 10.5 (range 6-22) and 889.4 mg/m(2) (range 484.5-1875.0 mg/m(2)), respectively. The peripheral neurotoxicity was evaluated during mFOLFOX6 therapy and after its discontinuation using NCI-CTCAE ver. 3.0 and DEB-NTC. Data were collected prospectively and analyzed retrospectively.
The concordance rate of the peripheral neurotoxicity grade determined by these criteria was low: 48.8% during mFOLFOX6 and 47.3% after discontinuation of therapy. The cumulative dose of oxaliplatin-related peripheral neurotoxicity in 50% of the patients was lower when evaluated by DEB-NTC for both grades 1 (P = 0.09) and 2 (P < 0.001). The cumulative rate of improvement from grade 2 to 1 (P < 0.001) and from grade 2 to 0 (P < 0.05) after discontinuation of mFOLFOX6 therapy was higher when NCI-CTCAE was used for the evaluation.
We found a discrepancy between the NCI-CTCAE and DEB-NTC scales in the evaluation of oxaliplatin-related neurotoxicity and suggest that the concomitant use of NCI-CTCAE and DEB-NTC would be useful to maintain oxaliplatin-based chemotherapy at higher quality.
International Journal of Clinical Oncology 08/2011; 17(4):341-7. DOI:10.1007/s10147-011-0298-z · 2.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This retrospective study was performed to clarify the efficacy and safety of FOLFOX regimen in aged patients with nonresectable colorectal cancer.
We had 92 patients with nonresectable colorectal cancer between December 2005 and March 2008. The rate of introducing modified FOLFOX6 (mFOLFOX6) regimen was compared among the patients aged 75 years or older (n = 22, aged group) and those aged 74 years or younger (n = 55, younger group). In addition, relative dose intensity (RDI), therapeutic efficacy, and adverse events in the patients who were given the regimen, we compared between the groups.
The rate of introducing the regimen was significantly lower in the aged group (36%, n = 8) than in the younger group (79%, n = 55) (p<0.01). The RDI tended to be lower in the aged group (68.0% versus 79.9%, p=0.10). There were no significant differences in the response rate, disease-control rate, progression-free survival, and overall survival between the groups. The rate of adverse events ( > or = grade 3) was not different between the groups ( 50% versus 51%).
Similar to younger patients the mFOLFOX6 regimen is feasible, safe and effective in the selected aged patients, although the dose reduction may be needed for such patients.
Gan to kagaku ryoho. Cancer & chemotherapy 12/2008; 35(12):2286-8.
[Show abstract][Hide abstract] ABSTRACT: This retrospective study was performed to evaluate a survival benefit of the full administration of 5-fluorouracil (5-FU), irinotecan (CPT-11), and oxaliplatin (L-OHP) to patients with unresectable or recurrent colorectal cancer.
The subjects are 145 patients with unresectable or recurrent colorectal cancer who were given CPT-11 and/or L-OHP in addition to 5-FU. The overall survival times of these patients were evaluated.
The median survival time (MST) was significantly longer in patients treated with three drugs (n=72) than patients treated with two drugs (n =73) (31.6 months versus 18.4 months, p<0.01). When analysis was restricted to patients treated with three drugs, there was no significant difference in MST between patients who were given L-OHP followed by CPT-11 (n=18) and those treated with these two drugs in reverse order (n=54) (p=0.67).
Compared with the use of 5-FU in combination with CPT-11 or L-OHP, a full administration of three drugs may have a more beneficial impact on patients' survival and irrespective of the order of administering CPT-11/L-OHP.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2008; 35(12):2289-91.