Chinese medical journal · 2025
Benefit of oxaliplatin-based chemotherapy or capecitabine monotherapy in older patients with stage III and high-risk stage II colon cancer: Data from the National Colorectal Cancer Cohort study in China.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Huang Fei, Xiao Tixian, Li Kexuan, Wei Ran, Mei Shiwen, Zhao Wei, Wei Fangze, He Maiyue, Zheng Zhaoxu, Liu Qian
Аннотация
BACKGROUND: Adjuvant chemotherapy is the standard management approach for patients with stage II/III colon cancer; however, the effectiveness in older patients is still unclear. This study aimed to explore the efficacy of adjuvant chemotherapy and whether oxaliplatin-based chemotherapy has better oncological outcomes than capecitabine monotherapy in older patients with stage III or high-risk stage II colon cancer.
METHODS: We analyzed and compared oxaliplatin-based adjuvant chemotherapy with capecitabine monotherapy and non-adjuvant chemotherapy in 468 patients aged ≥70 years with stage III and high-risk stage II colon cancer, and a propensity score-matched analysis was conducted. The endpoints were overall survival (OS), cancer-specific survival (CSS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS).
RESULTS: Multivariate analysis shows that adjuvant-treated stage III or high-risk stage II patients experienced a highly significant increase in OS (hazard ratio [HR]: 0.34, 95% confidence interval [CI]: 0.20-0.59, P <0.001) and CSS (HR: 0.39, 95% CI: 0.20-0.75, P = 0.005) compared with the control group without adjuvant chemotherapy. By contrast, no statistically significant difference was observed in either LRFS or DMFS (all P >0.05). The subgroup analysis suggested that no statistically significant benefits were observed between oxaliplatin-based adjuvant chemotherapy and capecitabine monotherapy, and no significant differences in oncological outcomes were detected with ≥6 months of therapy compared with 3-6 months (excluding 6 months) of therapy.
CONCLUSION: Older patients with stage III or high-risk stage II colon cancer can benefit from adjuvant chemotherapy, and capecitabine monotherapy has non-inferior oncological outcomes compared with oxaliplatin-based regimens.
CLINICAL TRIAL NUMBER: ClinicalTrials.gov , NCT04074538.
METHODS: We analyzed and compared oxaliplatin-based adjuvant chemotherapy with capecitabine monotherapy and non-adjuvant chemotherapy in 468 patients aged ≥70 years with stage III and high-risk stage II colon cancer, and a propensity score-matched analysis was conducted. The endpoints were overall survival (OS), cancer-specific survival (CSS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS).
RESULTS: Multivariate analysis shows that adjuvant-treated stage III or high-risk stage II patients experienced a highly significant increase in OS (hazard ratio [HR]: 0.34, 95% confidence interval [CI]: 0.20-0.59, P <0.001) and CSS (HR: 0.39, 95% CI: 0.20-0.75, P = 0.005) compared with the control group without adjuvant chemotherapy. By contrast, no statistically significant difference was observed in either LRFS or DMFS (all P >0.05). The subgroup analysis suggested that no statistically significant benefits were observed between oxaliplatin-based adjuvant chemotherapy and capecitabine monotherapy, and no significant differences in oncological outcomes were detected with ≥6 months of therapy compared with 3-6 months (excluding 6 months) of therapy.
CONCLUSION: Older patients with stage III or high-risk stage II colon cancer can benefit from adjuvant chemotherapy, and capecitabine monotherapy has non-inferior oncological outcomes compared with oxaliplatin-based regimens.
CLINICAL TRIAL NUMBER: ClinicalTrials.gov , NCT04074538.