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Feasibility of capecitabine and oxaliplatin combination (XELOX) chemotherapy without central venous access device in patients with stage III colorectal cancer

Abstract : Background - 5-Fluorouracil and leucovorin plus oxaliplatin (FOLFOX) or capecitabine plus oxaliplatin (XELOX) is a standard adjuvant treatment for patients with stage III colon cancer (CC). Capecitabine is an oral fluoropyrimidine, and administration of oxaliplatin does not necessarily require the insertion of a central venous access device (CVAD). We evaluated the feasibility of XELOX without a CVAD as adjuvant treatment in patients with stage III CC. Patients and methods - We retrospectively studied prospectively collected data from patients with stage III CC treated with XELOX in the International Duration Evaluation of Adjuvant Chemotherapy French trial. Patients were divided into 2 groups: those with a CVAD and those with peripheral venous access (PVA), including patients who had and had not had a CVAD at the first cycle of chemotherapy. Chemotherapy without a CVAD was considered feasible if the patient received all cycles of adjuvant therapy without it. Results - A total of 203 patients were included: 86 (43%) in the PVA group and 116 (57%) in the CVAD group. Of the 85 patients in the PVA group (1 patient was not treated), 69 (81.2%) did not require the insertion of a CVAD. However, 16 (18.8%) required CVAD insertion owing to systematic delay of the initially planned CVAD before the second cycle of chemotherapy in 7, complications related to PVA usage in 5, a switch to the modified FOLFOX6 regimen in 2, and other reasons in 2. The oxaliplatin dose was similar in both groups regardless of the chemotherapy duration. XELOX without a CVAD was feasible for 81.2% of the patients for whom a CVAD had not been planned before chemotherapy and for 88.4% of patients for whom chemotherapy was planned without the use of a CVAD. Conclusion - XELOX chemotherapy without a CVAD is a feasible approach for treating patients with stage III CC in the adjuvant setting.
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Submitted on : Thursday, January 14, 2016 - 2:01:27 PM
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Alexandra Lapeyre-Prost, Marine Larauze, Benoist Chibaudel, Marie Line Garcia, Veronique Guering-Meyer, et al.. Feasibility of capecitabine and oxaliplatin combination (XELOX) chemotherapy without central venous access device in patients with stage III colorectal cancer. Clinical Colorectal Cancer, Elsevier, 2016, 15 (3), pp.250-256. ⟨10.1016/j.clcc.2015.11.004⟩. ⟨hal-01239814⟩

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