PMID- 22294436
OWN - NLM
STAT- MEDLINE
DCOM- 20121024
LR  - 20211021
IS  - 1097-0142 (Electronic)
IS  - 0008-543X (Print)
IS  - 0008-543X (Linking)
VI  - 118
IP  - 17
DP  - 2012 Sep 1
TI  - Comparison of adverse events during 5-fluorouracil versus 
      5-fluorouracil/oxaliplatin adjuvant chemotherapy for stage III colon cancer: a 
      population-based analysis.
PG  - 4309-20
LID - 10.1002/cncr.27422 [doi]
AB  - BACKGROUND: In clinical trials, combined 5-fluorouracil (5FU) plus oxaliplatin 
      improves the survival of patients who have resected, stage III colon cancer with 
      manageable toxicity. However, the tolerability of this in the general population 
      of patients with colon cancer is uncertain. METHODS: Adverse outcomes were 
      compared in patients with stage III colon cancer who received either 5FU or 
      5FU/oxaliplatin within 120 days of undergoing resection versus a control group of 
      patients with stage II colon cancer who did not receive chemotherapy in the 
      Surveillance, Epidemiology, and End Results (SEER)-Medicare database and in data 
      from the New York State Cancer Registry linked to Medicare and Medicaid. 
      Hospitalizations, emergency room (ER) visits, and outpatient adverse events (AEs) 
      were measured in claims from 30 days to 9 months after patients underwent 
      resection. Multiple logistic regression was used to calculate adjusted odds 
      ratios of events by treatment. Propensity score matching was used to minimize 
      selection bias. RESULTS: Adverse outcomes were more frequent for chemotherapy 
      recipients. AE rates were higher in patients who received 5FU/oxaliplatin (81%) 
      compared with patients who received 5FU alone (72%), in the SEER-Medicare data. 
      The effect of oxaliplatin on AEs was greater in older patients: The odds ratio 
      was 2.10 (95% confidence interval, 1.53-2.87) for patients aged >/= 75 years versus 
      1.75 (95% confidence interval, 1.39-2.21) for patients aged <75 years. ER use was 
      high in Medicaid patients (83% of those who received chemotherapy), but neither 
      ER use nor hospitalization was increased by oxaliplatin. The 60-day mortality 
      rate was 1% to 3% for patients who received 5FU alone and 1% to 2% for patients 
      who received combined 5FU/oxaliplatin. CONCLUSIONS: The incremental harms of 
      adjuvant chemotherapy with 5FU/oxaliplatin versus 5FU alone were modest in 
      patients with stage III colon cancer who were insured by Medicare and Medicaid. 
      The additional harms in patients aged >/= 75 years largely were restricted to 
      outpatient events and did not extend to an increased rate of hospitalization or 
      early death.
CI  - Copyright (c) 2012 American Cancer Society.
FAU - Sanoff, Hanna K
AU  - Sanoff HK
AD  - Department of Medicine, Division of Hematology and Oncology, University of 
      Virginia, Charlottesville, Virginia, USA.
FAU - Carpenter, William R
AU  - Carpenter WR
FAU - Freburger, Janet
AU  - Freburger J
FAU - Li, Ling
AU  - Li L
FAU - Chen, Kun
AU  - Chen K
FAU - Zullig, Leah L
AU  - Zullig LL
FAU - Goldberg, Richard M
AU  - Goldberg RM
FAU - Schymura, Maria J
AU  - Schymura MJ
FAU - Schrag, Deborah
AU  - Schrag D
LA  - eng
GR  - R01CA131847/CA/NCI NIH HHS/United States
GR  - R25 CA116339/CA/NCI NIH HHS/United States
GR  - 1 R25 CA11633901/CA/NCI NIH HHS/United States
GR  - K05 CA169384/CA/NCI NIH HHS/United States
GR  - R01 CA131847/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
DEP - 20120131
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
RN  - 0 (Organoplatinum Compounds)
RN  - 04ZR38536J (Oxaliplatin)
RN  - U3P01618RT (Fluorouracil)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/administration & dosage/*adverse 
      effects
MH  - Chemotherapy, Adjuvant
MH  - Colonic Neoplasms/*drug therapy/pathology
MH  - Female
MH  - Fluorouracil/administration & dosage/*adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Organoplatinum Compounds/*adverse effects
MH  - Oxaliplatin
MH  - Population Surveillance
PMC - PMC3543676
MID - NIHMS428952
COIS- Financial Disclosure Authors report no financial COI.
EDAT- 2012/02/02 06:00
MHDA- 2012/10/25 06:00
PMCR- 2013/03/01
CRDT- 2012/02/02 06:00
PHST- 2011/11/04 00:00 [received]
PHST- 2011/12/09 00:00 [revised]
PHST- 2011/12/19 00:00 [accepted]
PHST- 2012/02/02 06:00 [entrez]
PHST- 2012/02/02 06:00 [pubmed]
PHST- 2012/10/25 06:00 [medline]
PHST- 2013/03/01 00:00 [pmc-release]
AID - 10.1002/cncr.27422 [doi]
PST - ppublish
SO  - Cancer. 2012 Sep 1;118(17):4309-20. doi: 10.1002/cncr.27422. Epub 2012 Jan 31.