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Toxicity of Oxaliplatin Plus Fluorouracil/Leucovorin Adjuvant Chemotherapy in Elderly Patients with Stage III Colon Cancer: A Population-Based Study

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Results concerning the side effects of oxaliplatin associated with fluorouracil and leucovorin (FOLFOX) in older patients are controversial. The objective of this study was to assess the use and the toxicity of FOLFOX in patients aged 70 years and older as administered in current practice.

Methods

Among 305 stage III colon cancers registered in a well-defined population in Burgundy between 2004 and 2009, 210 had adjuvant chemotherapy, including 156 with FOLFOX. The cumulated rates of toxicity were calculated by using the Kaplan–Meier method. The risks of overall toxicity and of severe toxicity (grade 3 or 4) in patients less than 70 years and in older patients were compared by using a Cox model.

Results

There was no difference between the group of the patients less than 70 years and the older age group for the cumulative incidence of hematologic, neurologic, digestive, and general toxicity. There was also no difference between the two groups for the severity of side effects (grade 3 or 4, 31.4 vs. 39.0 %; p = 0.576). The multivariate analysis indicated after adjustment on sex and the Charlson comorbidity score that there was no difference between the two age groups for toxicity (hazard ratio = 1.28; 95 % CI 0.68–2.41; p = 0.439).

Conclusions

Cancer registries can be used to evaluate the toxicity of chemotherapy at the population level. Tolerance to the FOLFOX regimen among elderly patients did not significantly differ from that in younger patients. This treatment should be considered regardless of patients’ age alone, but consideration should be given to the capacity of patients to tolerate adverse events.

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Acknowledgment

This work was supported by a Grant from the Ligue Régionale Contre le Cancer (2010). The authors thank all the gastroenterologists for their involvement: Drs. Abdelmajid, André, Bellecoste, Bruneton, Derreveaux, El Khaddari, Fabre, Grozel, Guillaume, Lacourt, Levenq, Naouri, Petigny, Ramond, Saggio, Soupison, and Van Nieuwenhuyse. They also thank all the private and public physicians, specialists, and pathologists for their collaboration.

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None of the authors has any conflicts of interest to declare regarding this study.

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Authors and Affiliations

  1. Digestive Cancer Registry of Burgundy, INSERM U866, University Hospital, University of Burgundy, Dijon, France

    Samia Hamza MD, Anne-Marie Bouvier MD, PhD, Fabien Rollot PhD, Côme Lepage MD, PhD, Jean Faivre MD, PhD & Laurent Bedenne MD, PhD

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  1. Samia Hamza MD
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  2. Anne-Marie Bouvier MD, PhD
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  3. Fabien Rollot PhD
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  4. Côme Lepage MD, PhD
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  5. Jean Faivre MD, PhD
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  6. Laurent Bedenne MD, PhD
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Corresponding author

Correspondence to Anne-Marie Bouvier MD, PhD.

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Hamza, S., Bouvier, AM., Rollot, F. et al. Toxicity of Oxaliplatin Plus Fluorouracil/Leucovorin Adjuvant Chemotherapy in Elderly Patients with Stage III Colon Cancer: A Population-Based Study. Ann Surg Oncol 21, 2636–2641 (2014). https://doi.org/10.1245/s10434-013-3438-z

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  • DOI: https://doi.org/10.1245/s10434-013-3438-z

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