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

Alexandra Lapeyre-Prost (1) , Marine Hug De Larauze (2) , Benoist Chibaudel (3) , Marie Line Garcia (2) , Veronique Guering-Meyer (4) , Olivier Bouché (5) , Eveline Boucher (6, 7) , Marc Ychou (8, 9) , Jérôme Dauba (10) , Stéphane Obled (11) , Astrid Lièvre (12, 13) , David Malka (14) , Roger Faroux (15) , Isabelle Bonnet (16) , Julien Taieb (1, 17) , Thierry André (2, 18)

1 HEGP - Hôpital Européen Georges Pompidou [APHP]
2 CHU Saint-Antoine [AP-HP]
3 Division of Medical Oncology - Institut Hospitalier Franco-Britannique
4 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
5 UMA-CH - Unité de Médecine Ambulatoire-Cancérologie Hématologie
6 Foie, métabolismes et cancer
7 Département d'oncologie médicale [Rennes]
8 Service d'oncologie digestive
9 IRCM - U1194 Inserm - UM - Institut de Recherche en Cancérologie de Montpellier
10 Service oncologie
11 CHU Nîmes - Hôpital Universitaire Carémeau [Nîmes]
12 UVSQ - Université de Versailles Saint-Quentin-en-Yvelines
13 CRLCC René Huguenin
14 IGR - Institut Gustave Roussy
15 Centre Hospitalier Départemental La Roche sur Yon
16 Hôpital Jean Bernard
17 Fédération Francophone de la Cancérologie Digestive, FFCD
18 UPMC - Université Pierre et Marie Curie - Paris 6

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.

Keywords: peripheral venous access; colon cancer; central venous access device; adjuvant chemotherapy; XELOX

Domains: Life Sciences [q-bio]; Life Sciences [q-bio]; Human health and pathology

Alexandra Lapeyre-Prost, Marine Hug De 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, 2016, 15 (3), pp.250-256. ⟨10.1016/j.clcc.2015.11.004⟩. ⟨hal-01239814⟩