Difference between Complete Oxaliplatin Based Adjuvant Chemotherapy and Incomplete Course in Stage III Colorectal Cancer Patients in Taiwan

Purpose. We have analyzed stage III colorectal patients who cannot receive complete course oxaliplatin based adjuvant chemotherapy (FOLFOX). We have followed up this group of patients, and have gained information for the patients who cannot complete adjuvant chemotherapy in the aspect of overall survival and recurrence rate. Patients and Methods. This was a case control study. We retrospectively analyzed stage III colorectal cancer patients who received adjuvant chemotherapy at Taichung Veteran General Hospital (VGHTC) from Jan. 2005 to Dec. 2012. The patients were enrolled and classified according to the duration of chemotherapy. Consequence of disease free survival (DFS), overall survival (OS) will be analyzed. Result. Two-year disease free survival (DFS) rates were 86.7% and 82.1% in patients’ receiving incomplete course FOLFOX and complete course FOLFOX respectively (Hazard ratio: [HR] = 0.70, 95% CI, 0.38 to 1.30, p = 0.254). Five-year overall survival rates (OS) were 77.2% and 79.0% in patients’ receiving incomplete course FOLFOX and complete course FOLFOX respectively (Hazard ratio: [HR] = 1.37, 95% CI, 0.69 to 2.78, p = 0.366). 49% patients cannot complete full-course adjuvant chemotherapy FOLFOX. The most frequent reasons of incomplete chemotherapy were severe gastrointestinal side effect and sensory neuropathy. The recurrent pattern were liver, lung metastasis, and peritoneum seeding in both groups. In the stage of 3A + 3B incomplete group, non-inferior trend in DFS and OS was noted. In the stage of 3C complete course group, superior trend in overall survival was noted. Conclusion. For stage III colorectal cancer adjuvant chemotherapy setting, incomplete course FOLFOX didn’t get worse in overall survival. There was also a leading trend toward complete course in DFS. But in the stage of 3C colorectal cancer patients, complete course FOLFOX was an indicator for better OS. The result was pending further larger randomized clinical trial.