Evidence map›Paper›PMID 29685155›Full record

ArticleBMC cancer2018

Chemotherapy for metastatic colon cancer: No effect on survival when the dose is reduced due to side effects.

Stefan Munker, Michael Gerken, Petra Fest, Claudia Ott, Elisabeth Schnoy, Stefan Fichtner-Feigl, Philipp Wiggermann, Martin Vogelhuber, Wolfgang Herr, Christian Stroszczynski and 5 more

Open access · goldAbstract read
In one paragraph

Article in BMC cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed
1.9field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 52 citations in OpenAlex.

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  11. Medicinal Characteristics ofPharmaceuticals (Basel, Switzerland) · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 1 country.

Stefan MunkerDepartment of Internal Medicine I, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, 95053, Regensburg, Germany. stefan.munker@klinik.uni-regensburg.de.
Michael GerkenCancer Center, Institute for quality assurance and health services research, University of Regensburg, Regensburg, Germany.
Petra FestMedical Informatics Unit, University Hospital Regensburg, Regensburg, Germany.
Claudia OttDepartment of Internal Medicine I, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, 95053, Regensburg, Germany.
Elisabeth SchnoyDepartment of Internal Medicine I, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, 95053, Regensburg, Germany.
Stefan Fichtner-FeiglDepartment of Surgery, University Hospital Regensburg, Regensburg, Germany.
Philipp WiggermannDepartment of Radiology, University Hospital Regensburg, Regensburg, Germany.
Martin VogelhuberDepartment of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany.
Wolfgang HerrDepartment of Internal Medicine III, University Hospital Regensburg, Regensburg, Germany.
Christian StroszczynskiDepartment of Radiology, University Hospital Regensburg, Regensburg, Germany.
Hans Jürgen SchlittDepartment of Surgery, University Hospital Regensburg, Regensburg, Germany.
Matthias EvertDepartment of Pathology, University Hospital Regensburg, Regensburg, Germany.
Michael RengMedicDAT GmbH, Regensburg, Germany.
Monika Klinkhammer-SchalkeCancer Center, Institute for quality assurance and health services research, University of Regensburg, Regensburg, Germany.
Andreas TeufelDepartment of Internal Medicine I, University Hospital Regensburg, Franz-Josef-Strauss Allee 11, 95053, Regensburg, Germany. andreas.teufel@klinik.uni-regensburg.de.
University Hospital Regensburg · DEUniversity of Regensburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background5-Fluorouracil (5FU), Folinic acid (FA), and Oxaliplatin (FOLFOX) or 5FU, FA, and Irinotecan (FOLFIRI) are standard regimens for palliative chemotherapy of metastatic colon cancer. Since data showing the influence of dose reduction in palliative treatment are rare, the objective of this single center, retrospective study was to further characterize the influence of dose reduction on efficacy of these therapeutic regimens.

methodsOne hundred nine patients, diagnosed with stage IV colon cancer between 2004 and 2012 and receiving palliative first-line chemotherapy with either FOLFOX or FOLFIRI regimens in our outpatient clinic were analyzed for treatment efficacy. Patients who received dose reductions due to side effects usually received doses of 80% or lower of per protocol dose. Survival data were obtained from the Regensburg Tumor Registry. Survival analysis was performed using Kaplan-Meier statistical analysis and multivariable analysis.

resultsA dose reduction due to side effects was necessary in 46 (42%) patients. Dose reduction was independent of age. Major reasons for dose reduction were neutropenia (30%) followed by polyneuropathy (16%) and diarrhea (14%). Dosage was more often reduced in patients receiving FOLFOX based therapy. Comparison of patients with dose reduction versus patients with full dosage showed no significant difference on overall survival (p = 0.430). Subgroup analysis revealed dose reduction in patients with N2 stage disease was associated with improved survival. Patients who underwent dose reduction received more cycles of chemotherapy (13.7 vs. 10.8 cycles) and cumulative dosage was similar in both groups.

conclusionContrary to our expectations, the need to reduce chemotherapy dosage due to side effects does not indicate a worse prognosis in our retrospective analysis. We believe this can in part be explained by better adaption to interindividual pharmacokinetics and longer time of treatment.

Indexed as

AgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCamptothecinColorectal NeoplasmsFemaleFluorouracilHumansLeucovorinMaleMiddle AgedNeoplasm GradingNeoplasm MetastasisNeoplasm StagingOrganoplatinum CompoundsPalliative CareCamptothecinFluorouracilLeucovorinOrganoplatinum CompoundsCancerChemotherapyColorectal cancerDose reduction

Identifiers

PMID29685155
PMCPMC5913883
OpenAlexW2803034454

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.