Choice Of Cycles For Oxaliplatin-based Adjuvant Chemotherapy In The Treatment Of Stage ? Colon Cancer

Objectice:Six months of oxaliplatin-based adjuvant chemotherapy has become the standard treatment for patients with stage III colon cancer.Many patients,however,develop peripheral sensory neuropathy(PSN)during the standard 6-month administration of adjuvant therapy,leading to treatment modification or discontinuation.The latest experimental research shows that reduce adjuvant chemotherapy cycle can not only reduce the adverse effects of chemotherapy,but also achieve the same therapeutic effect,bringing survival benefits to patients.The purpose of this study was to investigate the difference in survival of patients after different adjuvant chemotherapy cycles,and to further explore the prognostic factors of postoperative colon cancer patients.Methods:The present study was a retrospective study,the patients with stage III colon cancer were collected from January 2015 to January 2017 in the Fourth Hospital of Hebei Medical University,analysis the relationship between adjuvant chemotherapy therapy cycle and survival,the primary end point was disease-free survival,and the secondary end point was the peripheral sensory neuropathy last 3 years.Results:Among the 144 patients included in the study who underwent radical resection for III stage colon cancer,144 patients had a disease-free survival analysis and 142 patients had a lasting three-year peripheral sensory neuropathy.In the disease-free survival analysis,47 patients received 4 cycles XELOX chemotherapy,36 patients received 8 cycles of XELOX chemotherapy,31 patients received 6 cycles of m FOLFOX6 chemotherapy,and 30 patients received 12 cycles of m FOLFOX6 chemotherapy.Disease-free survival analysis results showed that 3 months and 6 months 3 years in m FOLFOX6 disease-free survival rates were 65.0% and 86.7%,respectively,3 months and 6 months to 3 years in XELOX disease-free survival rates were 46.8% and 80.6%,respectively.It showed that in patients received adjuvant chemotherapy 6 months have a better outcomes than patients who received 3 months(P = 0.049).Subgroup analysis showed that for low-risk patients received XELOX regimen,3-year DFS at 3 months was 85.0%,and 3-year DFS at 6 months was 70.6%,P=0.048.For high-risk patients received XELOX regimen and low-risk and high-risk patients received m FOLFOX6 regimen,DFS at 6 months was better than at 3 months(P < 0.05),showing statistically significant differences.As about the analysis of lasting 3 years of peripheral sensory neuropathy,3 months and 6 months in m FOLFOX6 regimen the lasting 3 years peripheral sensory neuropathy rates were 9.70% and 73.3%,respectively;3 months and 6 months in XELOX regimen the lasting 3 years peripheral sensory neuropathy rates were 6.50% and 57.1%,respectively(P = 0.044),which showed that in patients received 6 months are more likely to have continuous peripheral sensory neuropathy than received 3 months.Conclusions:1.A 3-month chemotherapy regimen of XELOX may be the most appropriate treatment option for colon cancer,particular in low-risk patients.And the number of adjuvant chemotherapy cycles and N stages are independent factors affecting survival.2.Compared with 6 months of adjuvant chemotherapy,3 months of oxaliplatin-based adjuvant chemotherapy significantly reduced the incidence of peripheral sensory neuropathy.