Patterns of Adjuvant Chemotherapy Use in a Population-Based Cohort of Patients With Resected Stage II or III Colon Cancer

Abstract

After 2004, oxaliplatin and fluoropyrimidine-based therapy rapidly became the predominant adjuvant treatment for both stage II and stage III colon cancer in this large US cohort. Both increasing patient age and lower volume of an oncologist's practice were associated with early termination of adjuvant therapy.

Age-related inequalities in colon cancer treatment persist over time: a population-based analysis

“…In particular, it has been noted that older people with colon cancer typically receive less adjuvant chemotherapy than younger individuals and that the likelihood of receiving adjuvant chemotherapy decreases with age 22. Putative reasons for this include that evidence for the effectiveness of adjuvant chemotherapy in older populations is lacking 23.…”

Clinical trial design in older adults with cancer—The need for new paradigms

“…This has also been demonstrated in adjuvant colon cancer treatment in which older patients received less therapy despite proven efficacy of treatment. [59][60][61][62] Some reasons for undertreatment include a lack of adequate data for clinicians who may not be aware that fit older patients tolerate standard regimens with acceptable toxicity. Treatment of older patients can also require longer assessment time because of multiple comorbidities, polypharmacy, geriatric syndromes, and functional impairments.…”

Adjuvant chemotherapy

“…When analysed, population data indicate that the use in colon cancer follows the present recommendations (e.g. [39]), whereas greater variability has been reported for rectal cancer (e.g. [40]).…”