Evaluation of the Toxicity of Anticancer Chemotherapy in Patients with Colon Cancer

Abstract

Background. Modern anticancer chemotherapy can cause numerous adverse effects in the organism, whose functioning has already been disrupted by the neoplastic process itself. Objectives. The aim of the study was to evaluate and compare the frequency and severity of the toxicity of FOLFOX-4 and CLF-1 anticancer therapy in patients with colon cancer, and to analyze certain factors that might have increased the toxicity of the chemotherapy. Material and Methods. The study involved 64 patients suffering from generalized colon cancer, including 48 patients treated according to the FOLFOX-4 regimen and 16 patients treated according to the CLF-1 regimen. The toxicity of each regimen was analyzed on the basis of a confidential questionnaire formulated by the authors and laboratory research according to the extended WHO toxicity criteria. Results. The analysis of the symptoms of toxicity symptoms associated with the use of the FOLFOX-4 and CLF-1 therapeutic regimens revealed that the most common side effects included nausea and vomiting, despite ondansetron premedication, and neurotoxicity. Disruption of the functioning of the nervous system under the FOLFOX-4 regimen statistically significant exacerbation that increased with the number of chemotherapy cycles administered; this was more common and more severe in women. Paresthesia was also revealed to be a neurotoxic effect of the FOLFOX-4 regimen after termination of therapy. A statistically significant relationship was observed between the use of vitamin supplements and the incidence and severity of the toxicity of the FOLFOX-4 regimen. Conclusions. The findings of the current study regarding the toxicity of the FOLFOX-4 and CLF-1 therapy regimens should be taken into consideration when monitoring chemotherapy safety in colon cancer. The patients' tolerance of the administered medication and the side effects reported by patients should be constantly evaluated, which will help prevent these side effects, apply appropriate therapy and contribute to the improvement of the patients' quality of life. The functioning of the central nervous system should be carefully evaluated when planning the anticancer therapy, especially if repeated administration of neurotoxic drugs is necessary in cases of a recurrence of the disease. Chemotherapy should be thoroughly monitored for safety, especially in women over 65 years of age suffering from coexisting diseases. Colon cancer patients and their families should be informed of the risks of nutritional supplements before the start of the anticancer chemotherapy, and may need to dispense with their use (Adv Clin Exp Med 2015, 24, 1, 103-111).

Factors associated with the development and severity of oxaliplatin‐induced peripheral neuropathy: a systematic review

“…In the same study, weight per additional kilogram was associated with a slight decrease in risk of both acute and persistent neuropathy, which has been attributed to the fact that oxaliplatin is cleared in part via distribution into tissues . One study found increased risk among women, which was however not found in two other studies …”

“…An assessment of the quality of the 15 included studies was conducted based on criteria adapted from a previously published systematic review on oxaliplatin‐induced peripheral neuropathy and the STROBE Statement checklist (Table ). Only three studies were prospective, and the majority of studies failed to distinguish the acute and chronic forms of oxaliplatin‐induced peripheral neuropathy (Table ) . Seven studies investigated independent risk or prognostic factors by multivariate analyses .…”

“…The majority of studies, eight out of fifteen, analyzed patients who received the FOLFOX regimen, three with FOLFOX or XELOX, and one with XELOX (CAPOX) only, and three studies did not specify the regimen …”

Prognosis and treatment of FOLFOX therapy related interstitial pneumonia: a plea for multimodal immune modulating therapy in the respiratory insufficient patient

“…Although the overall incidence of digestive cancer is higher in men [40–42], the incidence of oxaliplatin-related non-pulmonary toxic symptoms (e.g., neurotoxicity) is higher in women [43], which thus leaves the question of a possible increase in male gender-related pulmonary toxicity unresolved.…”

Adverse drug reaction: a comparative analysis of protocols used for treatment of colorectal cancer

“…Cabe destacar, a relevância dos episódios de diarreia graus 3/4, no qual, levam a sérias complicações como desidratação, íleo paralítico, hipocalemia, obstrução intestinal, acidose metabólica ou até mesmo toxicidade renal. 22 Além disso, na última década, diversos estudos têm revelado que o polimorfismo genético tem sido determinante na ocorrência das toxicidades gastrointestinais graves. [23][24][25][26] Nessa perspectiva, a identificação de biomarcadores, a associação de terapias alvo moleculares com os esquemas mFOLFOX6 e FOLFIRI, assim como variações/modificações desses esquemas, vêm sendo investigadas e sugeridas com o intuito de minimizar as reações gastrointestinais severas.…”