Evidence map›Paper›PMID 36319973›Full record

ArticleBMC cancer2022

The influence of adjuvant chemotherapy dose intensity on overall survival in resected colon cancer: a multicentered retrospective analysis.

Daniel Breadner, Jonathan M Loree, Winson Y Cheung, Meghan Gipson, Suganija Lakkunarajah, Karen E Mulder, Jennifer L Spartlin, Shiying Kong, Philip Q Ding, Sharlene Gill and 1 more

Abstract read
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In one paragraph

Article in BMC cancer, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
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

8 citing papers in PubMed.

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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

11 authors.

Daniel BreadnerDepartment of Oncology, A3-924 LRCP Medical Oncology, London Regional Cancer Program, 800 Commissioners Road East, London, ON, N6A5W9, Canada. Daniel.breadner@lhsc.on.ca.
Jonathan M LoreeBC Cancer, Vancouver, BC, Canada.
Winson Y CheungDepartment of Oncology, Arnie Charbonneau Cancer Institute, Calgary, AB, Canada.
Meghan GipsonDepartment of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland.
Suganija LakkunarajahSchulich School of Medicine and Dentistry at, Western University, London, ON, Canada.
Karen E MulderDepartment of Oncology, Cross Cancer Institute, Edmonton, AB, Canada.
Jennifer L SpartlinDepartment of Oncology, Cross Cancer Institute, Edmonton, AB, Canada.
Shiying KongDepartment of Oncology, Arnie Charbonneau Cancer Institute, Calgary, AB, Canada.
Philip Q DingOncology Outcomes, Calgary, AB, Canada.
Sharlene GillBC Cancer, Vancouver, BC, Canada.
Stephen A WelchDepartment of Oncology, A3-924 LRCP Medical Oncology, London Regional Cancer Program, 800 Commissioners Road East, London, ON, N6A5W9, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundColorectal cancer remains the second leading cause of cancer death in North America. Fluorouracil and oxaliplatin based adjuvant chemotherapy for resected colon cancer (CC) reduces cancer recurrence, but also causes significant toxicity requiring dose reductions. The effect of dose intensity on survival outcomes is not fully understood and strengthening the evidence supports informed decision making between patients and oncologists.

methodsPatients treated with adjuvant chemotherapy, between 2006 and 2011, for resected colon cancer at four Canadian academic cancer centers were retrospectively analyzed. All patients must have received oxaliplatin with either capecitabine (CAPOX) or 5-FU (FOLFOX). Dose intensity (DI) was calculated as total delivered dose of an individual chemotherapy agent divided by the cumulative intended dose of that agent. The influence of DI on overall survival was examined.

resultsFive hundred thirty-one patients with high-risk stage II or stage III resected CC were eligible and included in the analysis. FOLFOX was the most common regimen (69.6%) with 29.7% of patients receiving CAPOX and 0.7% receiving both therapies. Median follow-up was 36.7 months. The median DI for 5-FU and capecitabine was 100% and 100% with 13.6% and 9.8% of patients receiving ≤ 80% DI, respectively. The median DI of oxaliplatin was 70% with 56.8% of patients receiving ≤ 80% DI. A DI of > 80% for each chemotherapy component was associated with a significant improvement in overall survival compared to those with a DI of ≤ 80% (5-FU HR = 0.23, 95% CI = 0.08-0.65, p = 0.006; capecitabine HR = 0.56, 95% CI = 0.33-0.94, p = 0.026; oxaliplatin HR = 0.52, 95% CI = 0.33-0.82, p = 0.005). Patients with T2 and/or N2 disease with an oxaliplatin DI > 80% had a trend towards improved survival (HR = 0.62, 95% CI = 0.38-1.02, p = 0.06).

conclusionsIn resected CC an adjuvant chemotherapy DI of > 80%, of each chemotherapy agent, is associated with improved overall survival.

Indexed as

Colonic NeoplasmsTesticular NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsCanadaCapecitabineChemotherapy, AdjuvantFluorouracilHumansLeucovorinMaleNeoplasm Recurrence, LocalNeoplasm StagingOrganoplatinum CompoundsOxaliplatinRetrospective StudiesCapecitabineFluorouracilLeucovorinOrganoplatinum CompoundsOxaliplatinAdjuvant colon cancerDose intensityOxaliplatinRelative dose intensityToxicity

Identifiers

PMID36319973
PMCPMC9628061

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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.