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Evre II-III Kolon Kanseri Tanılı Hastalarda 3 aylık ve 6 aylık Adjuvan Tedavi Rejimlerinin Değerlendirilmesi

Year 2022, Volume: 13 Issue: 3, 402 - 407, 27.09.2022
https://doi.org/10.18663/tjcl.1158511

Abstract

Amaç: Evre 2 kolon kanserinde, adjuvan kemoterapinin katkısı ve fluorourasil içeren rejimlere oxaliplatin eklenmesinin rolü tartışmalı iken, evre 3 hastalarda, ikili kombinasyon kemoterapileri tercih edilmekte olup tedavi süresi tartışılmaktadır. Biz de kliniğimizde takip ettiğimiz evre 2 ve evre 3 kolon kanseri hastalarında adjuvan kemoterapi rejimlerini, sürelerini, etki ve yan etki oranlarını ortaya koymayı amaçladık.
Gereç ve Yöntemler: Tıbbi Onkoloji Kliniğinde Ocak 2016 – Ocak 2022 tarihleri arasında takip ve tedavisi devam eden opere edilmiş evre 2 ve 3 kolon kanseri tanılı 236 hasta çalışmaya dahil edildi. Hastaların arşiv dosyalarından aldığı tedavi rejimleri ve süreleri, hastalıksız sağ kalım(HSK), genel sağ kalım (GS) arasındaki ilişki retrospektif olarak analiz edildi.
Bulgular: Hastaların 109’u (%46,2) evre 2 olarak, 127’si (%53,8) evre 3 olarak tanı almışlardı. Kemoterapi süresi ve hastalıksız sağ kalım(HSK) açısından bakıldığında, evre 3 hastalarda hesaplanan HSK, kemoterapi alınmadığında 22,8 ±3,3 ay, üç ay kemoterapi alındığında 43,8 ± 6,8, altı ay kemoterapi alındığında 80,5 ± 13,5 ay olarak gösterilmiş olup bu fark istatistiksel olarak anlamlıdır (p=0,047). evre 2 hastalarda ise kemoterapi süresi ve adjuvan kemoterapi almaması HSK istatistiksel olarak anlamlı fark oluşturmamıştır (p= 0,099). Ayrıca Evre 3 hastalarda Folfox(Folinik asit + Fluorourasil + Oksaliplatin) kemoterapisi verilenlerin HSK’sı diğer rejimlere göre anlamlı olarak düşük bulunmuştur (p=0.007).
Sonuçlar: Evre 2 hastalarda adjuvan tedavinin katkısı ve kemoterapi rejimleri arasında fark gösterilemezken, evre 3 hastalarda kemoterapi almayan ve 3 ay kemoterapi alan hastaların HSK süresi düşük bulunmuştur.

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References

  • 1. Katsaounou K, Nicolaou E, Vogazianos P, et al. Colon Cancer: From Epidemiology to Prevention. Metabolites. 2022 May 30;12(6):499. doi: 10.3390/metabo12060499. PMID: 35736432.
  • 2. Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nat Rev Gastroenterol Hepatol. 2019 Dec;16(12):713-732. (doi: 10.1038/s41575-019-0189-8.).
  • 3. Peterse EFP, Meester RGS, Siegel RL, et al. The impact of the rising colorectal cancer incidence in young adults on the optimal age to start screening: Microsimulation analysis I to inform the American Cancer Society colorectal cancer screening guideline. Cancer. 2018 Jul 15;124(14):2964-2973.(doi: 10.1002/cncr.31543).
  • 4. Vuik FE, Nieuwenburg SA, Bardou M, et al. Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years. Gut. 2019 Oct;68(10):1820-1826. (doi: 10.1136/gutjnl-2018-317592).
  • 5. Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin. 2017 Mar;67(2):93-99. (doi: 10.3322/caac.21388).
  • 6. Kobayashi H, Mochizuki H, Sugihara K, et al. Characteristics of recurrence and surveillance tools after curative resection for colorectal cancer: a multicenter study. Surgery. 2007 Jan;141(1):67-75.( doi: 10.1016/j.surg.2006.07.020).
  • 7. Boland GM, Chang GJ, Haynes AB, et al. Association between adherence to National Comprehensive Cancer Network treatment guidelines and improved survival in patients with colon cancer. Cancer. 2013 Apr 15;119(8):1593-601.( doi: 10.1002/cncr.27935).
  • 8. Quasar Collaborative Group, Gray R, Barnwell J, et al. Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet. 2007 Dec 15;370(9604):2020-9. (doi: 10.1016/S0140-6736(07)61866-2).
  • 9. André T, de Gramont A, Vernerey D, et al. Adjuvant Fluorouracil, Leucovorin, and Oxaliplatin in Stage II to III Colon Cancer: Updated 10-Year Survival and Outcomes According to BRAF Mutation and Mismatch Repair Status of the MOSAIC Study. J Clin Oncol. 2015 Dec 10;33(35):4176-87.( doi: 10.1200/JCO.2015.63.4238).
  • 10. Haller DG, Tabernero J, Maroun J, et al. Capecitabine plus oxaliplatin compared with fluorouracil and folinic acid as adjuvant therapy for stage III colon cancer. J Clin Oncol. 2011 Apr 10;29(11):1465-71.( doi: 10.1200/JCO.2010.33.6297).
  • 11. Sobin LH, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours. John Wiley & Sons; 2011 Aug 31.
  • 12. Wells KO, Hawkins AT, Krishnamurthy DM, et al. Omission of Adjuvant Chemotherapy Is Associated With Increased Mortality in Patients With T3N0 Colon Cancer With Inadequate Lymph Node Harvest. Dis Colon Rectum. 2017 Jan;60(1):15-21.( doi: 10.1097/DCR.0000000000000729).
  • 13. Ribic CM, Sargent DJ, Moore MJ, et al. Tumor microsatellite-instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer. N Engl J Med. 2003 Jul 17;349(3):247-57.( doi: 10.1056/NEJMoa022289).
  • 14. Kim JE, Hong YS, Kim HJ, et al. Defective Mismatch Repair Status was not Associated with DFS and OS in Stage II Colon Cancer Treated with Adjuvant Chemotherapy. Ann Surg Oncol. 2015 Dec;22 Suppl 3:S630-7. (doi: 10.1245/s10434-015-4807-6).
  • 15. McCleary NJ, Meyerhardt JA, Green E, et al. Impact of age on the efficacy of newer adjuvant therapies in patients with stage II/III colon cancer: findings from the ACCENT database. J Clin Oncol. 2013 Jul 10;31(20):2600-6.( doi: 10.1200/JCO.2013).
  • 16. Schmoll HJ, Tabernero J, Maroun J, et al. Capecitabine Plus Oxaliplatin Compared With Fluorouracil/Folinic Acid As Adjuvant Therapy for Stage III Colon Cancer: Final Results of the NO16968 Randomized Controlled Phase III Trial. J Clin Oncol. 2015 Nov 10;33(32):3733-40. (doi: 10.1200/JCO.2015.60.9107).
  • 17. André T, Boni C, Navarro M, Tabernero J, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol. 2009 Jul 1;27(19):3109-16. (doi: 10.1200/JCO.2008.20.6771).
  • 18. Yothers G, O'Connell MJ, Allegra CJ, et al. Oxaliplatin as adjuvant therapy for colon cancer: updated results of NSABP C-07 trial, including survival and subset analyses. J Clin Oncol. 2011 Oct 1;29(28):3768-74. (doi: 10.1200/JCO.2011.36.4539).
  • 19. Grothey A, Sobrero AF, Shields AF, et al. Duration of Adjuvant Chemotherapy for Stage III Colon Cancer. N Engl J Med. 2018 Mar 29;378(13):1177-1188. (doi: 10.1056/NEJMoa1713709).
  • 20. Kotaka M, Shirasu H, Watanabe J, et al: Association of circulating tumor DNA dynamics with clinical outcomes in the adjuvant setting for patients with colorectal cancer from an observational GALAXY study in CIRCULATE--Japan. 2022 ASCO Gastrointestinal Cancers Symposium. Abstract 9. Presented January 20, 2022.
Year 2022, Volume: 13 Issue: 3, 402 - 407, 27.09.2022
https://doi.org/10.18663/tjcl.1158511

Abstract

Project Number

yok

References

  • 1. Katsaounou K, Nicolaou E, Vogazianos P, et al. Colon Cancer: From Epidemiology to Prevention. Metabolites. 2022 May 30;12(6):499. doi: 10.3390/metabo12060499. PMID: 35736432.
  • 2. Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nat Rev Gastroenterol Hepatol. 2019 Dec;16(12):713-732. (doi: 10.1038/s41575-019-0189-8.).
  • 3. Peterse EFP, Meester RGS, Siegel RL, et al. The impact of the rising colorectal cancer incidence in young adults on the optimal age to start screening: Microsimulation analysis I to inform the American Cancer Society colorectal cancer screening guideline. Cancer. 2018 Jul 15;124(14):2964-2973.(doi: 10.1002/cncr.31543).
  • 4. Vuik FE, Nieuwenburg SA, Bardou M, et al. Increasing incidence of colorectal cancer in young adults in Europe over the last 25 years. Gut. 2019 Oct;68(10):1820-1826. (doi: 10.1136/gutjnl-2018-317592).
  • 5. Amin MB, Greene FL, Edge SB, et al. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin. 2017 Mar;67(2):93-99. (doi: 10.3322/caac.21388).
  • 6. Kobayashi H, Mochizuki H, Sugihara K, et al. Characteristics of recurrence and surveillance tools after curative resection for colorectal cancer: a multicenter study. Surgery. 2007 Jan;141(1):67-75.( doi: 10.1016/j.surg.2006.07.020).
  • 7. Boland GM, Chang GJ, Haynes AB, et al. Association between adherence to National Comprehensive Cancer Network treatment guidelines and improved survival in patients with colon cancer. Cancer. 2013 Apr 15;119(8):1593-601.( doi: 10.1002/cncr.27935).
  • 8. Quasar Collaborative Group, Gray R, Barnwell J, et al. Adjuvant chemotherapy versus observation in patients with colorectal cancer: a randomised study. Lancet. 2007 Dec 15;370(9604):2020-9. (doi: 10.1016/S0140-6736(07)61866-2).
  • 9. André T, de Gramont A, Vernerey D, et al. Adjuvant Fluorouracil, Leucovorin, and Oxaliplatin in Stage II to III Colon Cancer: Updated 10-Year Survival and Outcomes According to BRAF Mutation and Mismatch Repair Status of the MOSAIC Study. J Clin Oncol. 2015 Dec 10;33(35):4176-87.( doi: 10.1200/JCO.2015.63.4238).
  • 10. Haller DG, Tabernero J, Maroun J, et al. Capecitabine plus oxaliplatin compared with fluorouracil and folinic acid as adjuvant therapy for stage III colon cancer. J Clin Oncol. 2011 Apr 10;29(11):1465-71.( doi: 10.1200/JCO.2010.33.6297).
  • 11. Sobin LH, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours. John Wiley & Sons; 2011 Aug 31.
  • 12. Wells KO, Hawkins AT, Krishnamurthy DM, et al. Omission of Adjuvant Chemotherapy Is Associated With Increased Mortality in Patients With T3N0 Colon Cancer With Inadequate Lymph Node Harvest. Dis Colon Rectum. 2017 Jan;60(1):15-21.( doi: 10.1097/DCR.0000000000000729).
  • 13. Ribic CM, Sargent DJ, Moore MJ, et al. Tumor microsatellite-instability status as a predictor of benefit from fluorouracil-based adjuvant chemotherapy for colon cancer. N Engl J Med. 2003 Jul 17;349(3):247-57.( doi: 10.1056/NEJMoa022289).
  • 14. Kim JE, Hong YS, Kim HJ, et al. Defective Mismatch Repair Status was not Associated with DFS and OS in Stage II Colon Cancer Treated with Adjuvant Chemotherapy. Ann Surg Oncol. 2015 Dec;22 Suppl 3:S630-7. (doi: 10.1245/s10434-015-4807-6).
  • 15. McCleary NJ, Meyerhardt JA, Green E, et al. Impact of age on the efficacy of newer adjuvant therapies in patients with stage II/III colon cancer: findings from the ACCENT database. J Clin Oncol. 2013 Jul 10;31(20):2600-6.( doi: 10.1200/JCO.2013).
  • 16. Schmoll HJ, Tabernero J, Maroun J, et al. Capecitabine Plus Oxaliplatin Compared With Fluorouracil/Folinic Acid As Adjuvant Therapy for Stage III Colon Cancer: Final Results of the NO16968 Randomized Controlled Phase III Trial. J Clin Oncol. 2015 Nov 10;33(32):3733-40. (doi: 10.1200/JCO.2015.60.9107).
  • 17. André T, Boni C, Navarro M, Tabernero J, et al. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol. 2009 Jul 1;27(19):3109-16. (doi: 10.1200/JCO.2008.20.6771).
  • 18. Yothers G, O'Connell MJ, Allegra CJ, et al. Oxaliplatin as adjuvant therapy for colon cancer: updated results of NSABP C-07 trial, including survival and subset analyses. J Clin Oncol. 2011 Oct 1;29(28):3768-74. (doi: 10.1200/JCO.2011.36.4539).
  • 19. Grothey A, Sobrero AF, Shields AF, et al. Duration of Adjuvant Chemotherapy for Stage III Colon Cancer. N Engl J Med. 2018 Mar 29;378(13):1177-1188. (doi: 10.1056/NEJMoa1713709).
  • 20. Kotaka M, Shirasu H, Watanabe J, et al: Association of circulating tumor DNA dynamics with clinical outcomes in the adjuvant setting for patients with colorectal cancer from an observational GALAXY study in CIRCULATE--Japan. 2022 ASCO Gastrointestinal Cancers Symposium. Abstract 9. Presented January 20, 2022.
There are 20 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Orıgınal Artıcle
Authors

Özgecan Dülgar

Seval Ay This is me

Ayşe Nur Toksöz Yıldırım

Project Number yok
Publication Date September 27, 2022
Published in Issue Year 2022 Volume: 13 Issue: 3

Cite

APA Dülgar, Ö., Ay, S., & Toksöz Yıldırım, A. N. (2022). Evre II-III Kolon Kanseri Tanılı Hastalarda 3 aylık ve 6 aylık Adjuvan Tedavi Rejimlerinin Değerlendirilmesi. Turkish Journal of Clinics and Laboratory, 13(3), 402-407. https://doi.org/10.18663/tjcl.1158511
AMA Dülgar Ö, Ay S, Toksöz Yıldırım AN. Evre II-III Kolon Kanseri Tanılı Hastalarda 3 aylık ve 6 aylık Adjuvan Tedavi Rejimlerinin Değerlendirilmesi. TJCL. September 2022;13(3):402-407. doi:10.18663/tjcl.1158511
Chicago Dülgar, Özgecan, Seval Ay, and Ayşe Nur Toksöz Yıldırım. “Evre II-III Kolon Kanseri Tanılı Hastalarda 3 aylık Ve 6 aylık Adjuvan Tedavi Rejimlerinin Değerlendirilmesi”. Turkish Journal of Clinics and Laboratory 13, no. 3 (September 2022): 402-7. https://doi.org/10.18663/tjcl.1158511.
EndNote Dülgar Ö, Ay S, Toksöz Yıldırım AN (September 1, 2022) Evre II-III Kolon Kanseri Tanılı Hastalarda 3 aylık ve 6 aylık Adjuvan Tedavi Rejimlerinin Değerlendirilmesi. Turkish Journal of Clinics and Laboratory 13 3 402–407.
IEEE Ö. Dülgar, S. Ay, and A. N. Toksöz Yıldırım, “Evre II-III Kolon Kanseri Tanılı Hastalarda 3 aylık ve 6 aylık Adjuvan Tedavi Rejimlerinin Değerlendirilmesi”, TJCL, vol. 13, no. 3, pp. 402–407, 2022, doi: 10.18663/tjcl.1158511.
ISNAD Dülgar, Özgecan et al. “Evre II-III Kolon Kanseri Tanılı Hastalarda 3 aylık Ve 6 aylık Adjuvan Tedavi Rejimlerinin Değerlendirilmesi”. Turkish Journal of Clinics and Laboratory 13/3 (September 2022), 402-407. https://doi.org/10.18663/tjcl.1158511.
JAMA Dülgar Ö, Ay S, Toksöz Yıldırım AN. Evre II-III Kolon Kanseri Tanılı Hastalarda 3 aylık ve 6 aylık Adjuvan Tedavi Rejimlerinin Değerlendirilmesi. TJCL. 2022;13:402–407.
MLA Dülgar, Özgecan et al. “Evre II-III Kolon Kanseri Tanılı Hastalarda 3 aylık Ve 6 aylık Adjuvan Tedavi Rejimlerinin Değerlendirilmesi”. Turkish Journal of Clinics and Laboratory, vol. 13, no. 3, 2022, pp. 402-7, doi:10.18663/tjcl.1158511.
Vancouver Dülgar Ö, Ay S, Toksöz Yıldırım AN. Evre II-III Kolon Kanseri Tanılı Hastalarda 3 aylık ve 6 aylık Adjuvan Tedavi Rejimlerinin Değerlendirilmesi. TJCL. 2022;13(3):402-7.


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