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Impact of dose-capping chemotherapy in concurrent chemoradiotherapy in rectal cancer patients.
- Source :
-
Journal of Oncology Pharmacy Practice . Oct2021, Vol. 27 Issue 7, p1596-1603. 8p. - Publication Year :
- 2021
-
Abstract
- 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. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10781552
- Volume :
- 27
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Journal of Oncology Pharmacy Practice
- Publication Type :
- Academic Journal
- Accession number :
- 152624574
- Full Text :
- https://doi.org/10.1177/1078155220962192