Abstract
Background
The optimal timing of adjuvant chemotherapy (AC) in non-metastatic colon cancer is
poorly defined. Delays in AC result in decreased survival. Effective cytotoxic treatments
should be considered during the perioperative phase of care. The immediate adjuvant
chemotherapy (IAC) concept intends to capitalize on the therapeutic benefits that
can be achieved in the perioperative period. We aim to demonstrate that IAC is safe
and tolerable.
Patient and Methods
Microsatellite stable invasive adenocarcinomas were treated with intravenous Leucovorin
20 mg/m2 and single dose of 5-Flurouracil 400mg/m2 at the time of surgery. High-risk
stage II and stage III received the first dose of standard AC at 14 days after surgery.
Serial measurements of blood-based biomarkers were measured. Quality of life (QOL)
was measured using EORTC QLQ-C30.
Results
Of the 20 patients recruited, 40% had final pathology of stage III, 40% stage II and
20% stage I. All patients received intra-operative chemotherapy with no associated
morbidity. Median length of stay was 2 days (range of 2-4). There was no intraoperative
morbidity with 5% (N = 1) grade 3 complication. AC was administered to 65% of patients.
The median time to AC was 14 days (range 14-36). Overall quality of life and health
scores were similar before surgery and at 30-day postoperatively (P < .05).
Conclusions
A protocol based on IAC starting at the time of surgical resection was found to be
safe and feasible with no adverse effects on surgical morbidity or quality of life.
Further prospective studies are needed to explore the oncologic benefit of this novel
systemic treatment approach.
Key Words
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Article Info
Publication History
Published online: November 28, 2021
Accepted:
November 22,
2021
Received in revised form:
October 19,
2021
Received:
July 23,
2021
Publication stage
In Press Journal Pre-ProofFootnotes
This study was funded/supported by Chao Family Comprehensive Cancer Center. This study was presented at Gastrointestinal Cancers Symposium. San Francisco, CA. January 18, 2019
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