Chemotherapy Toxicity Profile in Adjuvant Treated Colorectal Carcinoma Patients

Abstract

Background: Colorectal cancer (CRC) is the third most common cancer and the fourth leading cause of cancer-related deaths in the world. The treatment of stage III CRC consists of surgery followed by adjuvant chemotherapy with either single agent capecitabine or combination therapy consisting of FOLFOX or XELOX, all of which have been shown to be effective in improving dis ease-free survival (DFS) and overall survival (OS). However, toxicities acquired from chemotherapy can affect a cancer patient’s quality of life and result in early treatment discontinuation. Common toxicities include hematological, gastroin testinal (GI), constitutional, dermatological, and neurological . Aim of the Work: The present work was aimed to ass e ss and evaluate chemotherapy toxicities in adjuvant treatment in CRC patients and analyze certain factors that might increase chemotherapy toxicity . Patients and Methods: This is retrospective study included a total of 72 patients of colorectal carcinoma received adjuvant chemotherapy at Clinical Oncology Department, Ain Shams University. The study was conducted between Jan. 2012 and Jan. 2017. Results: We found that the most chemotherapy reported was neurological toxicity in (73.6%), gastroin testinal symptoms (diarrhea 52.7%, nausea 30.6%, vomiting 27.8% & oral mucositis 24%), hematological toxicity (neutropenia 40.3%, anemia 34.7%, thrombocytopenia 12.5%), fatigue 20.9%, hepatic toxicity 18.1%, dermatological toxicity 9.7% & renal toxicity 5.6%). older patients have significant incidence of neurological toxicity (p-value = 0.023) and fatigue (p-value = 0.038). females have significant incidence of anemia (p-value = 0.017). increase of oxaliplatin cumulative dose increase incidence of neurological toxicity (p-value = 0.024), thrombocytopenia (p-value = 0.007) and renal toxicity (p-value = 0.030). Oxaliplatin containing regimens have high significant correlation with neurological toxicity (p-value = 0.000) and capcitabine has high significant correlation with dermatological toxicity (p-value = 0.000) . Conclusion: The most overall toxicity reported during adjuvant treatment in CRC was neuro logical toxicity. Although a variety of adverse reactions were reported the treatme nt regimens were tolerated but we should take care of factors that may increase certain toxicity.