Real-World Effectiveness of Adjuvant Oxaliplatin Chemotherapy in Stage III Colon Cancer: A Controlled Interrupted Time Series Analysis
Background: The real-world effectiveness of oxaliplatin in stage III colon cancer has not been determined in a large-scale population. We aimed to assess the real-world impact of adjuvant oxaliplatin treatment on the survival of these patients.Methods: Based on Taiwan cancer registry, we evaluated 1...
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Frontiers Media S.A.
2021-06-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2021.693009/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Wen-Kuan Huang Wen-Kuan Huang Wen-Kuan Huang Hung-Chih Hsu Hung-Chih Hsu Shu-Hao Chang Wen-Chi Chou Wen-Chi Chou Pei-Hung Chang Pei-Hung Chang Sum-Fu Chiang John Wen-Cheng Chang John Wen-Cheng Chang Jen-Shi Chen Jen-Shi Chen Tsai-Sheng Yang Tsai-Sheng Yang Lai-Chu See Lai-Chu See Lai-Chu See |
spellingShingle |
Wen-Kuan Huang Wen-Kuan Huang Wen-Kuan Huang Hung-Chih Hsu Hung-Chih Hsu Shu-Hao Chang Wen-Chi Chou Wen-Chi Chou Pei-Hung Chang Pei-Hung Chang Sum-Fu Chiang John Wen-Cheng Chang John Wen-Cheng Chang Jen-Shi Chen Jen-Shi Chen Tsai-Sheng Yang Tsai-Sheng Yang Lai-Chu See Lai-Chu See Lai-Chu See Real-World Effectiveness of Adjuvant Oxaliplatin Chemotherapy in Stage III Colon Cancer: A Controlled Interrupted Time Series Analysis Frontiers in Pharmacology oxaliplatin adjuvant chemotherapy stage III colorectal cancer interrupted time series study mortality |
author_facet |
Wen-Kuan Huang Wen-Kuan Huang Wen-Kuan Huang Hung-Chih Hsu Hung-Chih Hsu Shu-Hao Chang Wen-Chi Chou Wen-Chi Chou Pei-Hung Chang Pei-Hung Chang Sum-Fu Chiang John Wen-Cheng Chang John Wen-Cheng Chang Jen-Shi Chen Jen-Shi Chen Tsai-Sheng Yang Tsai-Sheng Yang Lai-Chu See Lai-Chu See Lai-Chu See |
author_sort |
Wen-Kuan Huang |
title |
Real-World Effectiveness of Adjuvant Oxaliplatin Chemotherapy in Stage III Colon Cancer: A Controlled Interrupted Time Series Analysis |
title_short |
Real-World Effectiveness of Adjuvant Oxaliplatin Chemotherapy in Stage III Colon Cancer: A Controlled Interrupted Time Series Analysis |
title_full |
Real-World Effectiveness of Adjuvant Oxaliplatin Chemotherapy in Stage III Colon Cancer: A Controlled Interrupted Time Series Analysis |
title_fullStr |
Real-World Effectiveness of Adjuvant Oxaliplatin Chemotherapy in Stage III Colon Cancer: A Controlled Interrupted Time Series Analysis |
title_full_unstemmed |
Real-World Effectiveness of Adjuvant Oxaliplatin Chemotherapy in Stage III Colon Cancer: A Controlled Interrupted Time Series Analysis |
title_sort |
real-world effectiveness of adjuvant oxaliplatin chemotherapy in stage iii colon cancer: a controlled interrupted time series analysis |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Pharmacology |
issn |
1663-9812 |
publishDate |
2021-06-01 |
description |
Background: The real-world effectiveness of oxaliplatin in stage III colon cancer has not been determined in a large-scale population. We aimed to assess the real-world impact of adjuvant oxaliplatin treatment on the survival of these patients.Methods: Based on Taiwan cancer registry, we evaluated 17,801 patients with resected stage III colon cancer, including 14,168 patients receiving adjuvant chemotherapy and 3,633 not receiving adjuvant chemotherapy as the control group between 2004 and 2014. We used the controlled interrupted time-series analysis to assess the three-year disease-free survival and five-year overall survival rates before (2004–2008) and after (2009–2014) the addition of oxaliplatin.Results: The introduction of oxaliplatin was associated with no significant improvement in the slopes (per half-year) of the three-year disease-free survival rate (0.2%, 95% CI: −1.7∼2.2%) and five-year overall survival rate (0.6%, 95% CI: −1.8∼3%). The patients receiving oxaliplatin-based chemotherapy also showed no significant increase in the slopes (per half-year) of the three-year disease-free survival rate (0.6%, 95% CI: −1.4∼2.6%) and five-year overall survival rate (1%, 95% CI: −1.5∼3.5%). The nonsignificant results were consistent across subgroup analyses of age (<70 vs. ≥70 years), recurrence risk (T1-3 or N1 vs. T4 or N2), and cycle of oxaliplatin use (≤6 vs. >6). However, oxaliplatin-based chemotherapy significantly increased the slope (per half-year) of the five-year OS (2%, 95% CI: 0.2∼3.8%) for patients in the high-risk group (T4 or N2). The present results were robust in several sensitivity analyses.Conclusion: Among real-world patients with stage III colon cancer, the introduction of oxaliplatin does not yield a significant improvement in survival. Future work should identify the subpopulation(s) of patients who benefit significantly from the addition of oxaliplatin. |
topic |
oxaliplatin adjuvant chemotherapy stage III colorectal cancer interrupted time series study mortality |
url |
https://www.frontiersin.org/articles/10.3389/fphar.2021.693009/full |
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doaj-1e5e9eac6b654316bbd5a0df73512c1f2021-06-29T05:44:45ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-06-011210.3389/fphar.2021.693009693009Real-World Effectiveness of Adjuvant Oxaliplatin Chemotherapy in Stage III Colon Cancer: A Controlled Interrupted Time Series AnalysisWen-Kuan Huang0Wen-Kuan Huang1Wen-Kuan Huang2Hung-Chih Hsu3Hung-Chih Hsu4Shu-Hao Chang5Wen-Chi Chou6Wen-Chi Chou7Pei-Hung Chang8Pei-Hung Chang9Sum-Fu Chiang10John Wen-Cheng Chang11John Wen-Cheng Chang12Jen-Shi Chen13Jen-Shi Chen14Tsai-Sheng Yang15Tsai-Sheng Yang16Lai-Chu See17Lai-Chu See18Lai-Chu See19Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Oncology-Pathology, Karolinska Institutet, Stockholm, SwedenDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Public Health, College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanDivision of Colon and Rectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanCollege of Medicine, Chang Gung University, Taoyuan, TaiwanDepartment of Public Health, College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, TaiwanBiostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan, TaiwanBackground: The real-world effectiveness of oxaliplatin in stage III colon cancer has not been determined in a large-scale population. We aimed to assess the real-world impact of adjuvant oxaliplatin treatment on the survival of these patients.Methods: Based on Taiwan cancer registry, we evaluated 17,801 patients with resected stage III colon cancer, including 14,168 patients receiving adjuvant chemotherapy and 3,633 not receiving adjuvant chemotherapy as the control group between 2004 and 2014. We used the controlled interrupted time-series analysis to assess the three-year disease-free survival and five-year overall survival rates before (2004–2008) and after (2009–2014) the addition of oxaliplatin.Results: The introduction of oxaliplatin was associated with no significant improvement in the slopes (per half-year) of the three-year disease-free survival rate (0.2%, 95% CI: −1.7∼2.2%) and five-year overall survival rate (0.6%, 95% CI: −1.8∼3%). The patients receiving oxaliplatin-based chemotherapy also showed no significant increase in the slopes (per half-year) of the three-year disease-free survival rate (0.6%, 95% CI: −1.4∼2.6%) and five-year overall survival rate (1%, 95% CI: −1.5∼3.5%). The nonsignificant results were consistent across subgroup analyses of age (<70 vs. ≥70 years), recurrence risk (T1-3 or N1 vs. T4 or N2), and cycle of oxaliplatin use (≤6 vs. >6). However, oxaliplatin-based chemotherapy significantly increased the slope (per half-year) of the five-year OS (2%, 95% CI: 0.2∼3.8%) for patients in the high-risk group (T4 or N2). The present results were robust in several sensitivity analyses.Conclusion: Among real-world patients with stage III colon cancer, the introduction of oxaliplatin does not yield a significant improvement in survival. Future work should identify the subpopulation(s) of patients who benefit significantly from the addition of oxaliplatin.https://www.frontiersin.org/articles/10.3389/fphar.2021.693009/fulloxaliplatinadjuvant chemotherapystage III colorectal cancerinterrupted time series studymortality |