Therapeutic Characteristics, Chemotherapy-Related Toxicities and Survivorship in Colorectal Cancer Patients

Abstract

Background: Colorectal Cancer (CRC) is a major health problem around the globe. In Morocco, the disease ranks third after breast and lung cancers. This study is the first in Morocco to investigate epidemiological, clinical and therapeutic features while exhaustively describing toxic side-effects to chemotherapy of CRC and studying the 3-years survivorship.

Methods: This is a descriptive and analytical retrospective study of about 290 patients with CRC enrolled during the period of January-December 2013. Statistical analysis was performed to correlate clinicopathological data with chemotherapy toxicity and survivorship in patients, by Chi² test. Overall Survival (OS) rate has been calculated by the Kaplan-Meier method and compared using Log-rank test.

Results: Fifty-five percent had a tumor localized in rectum, and 42,8% in colon. Mean age of these patients at diagnosis was 56,16 ± 14,6. incidence rate of adverse events (grade I to IV) was 85,6%. Diarrhea was the predominant toxicity (4.6%) occurring at a high grade (grade III-IV).The 3-years OS rate of patients with CRC was 71%. OS decreased by age, and patients with age subgroup between 40 to 59 years had a better OS than the other age subgroups (60 to 79 years and >80 years) with a p-value of 0.0001. Occurence of toxicity (all grades and types) was linked to a higher survival rates compared to the group who had no toxicity noticed (p-value of 0.001).

Conclusion: Our study shows that patients who had a polychemotherapy had a better OS than those who had monotherapy (p-value of 0.002).

Keywords: Colorectal cancer; chemotherapy toxicities; overall survival (OS).

Figure 1

Overall survival in colorectal cancer patients Key= a- relationship between age (age ranges) and the overall survival (OS), b- relationship between tumor extension (metastatic sites) and the OS, c- relationship between presence of metastasis and the OS, d- relationship between stage of the tumor at diagnosis and the OS, e- relationship between treatment by chemotherapy and OS, f- relationship between types of chemotherapy and the OS, g- relationship between occurrence of toxicity and the OS, h- relationship between treatment by chemoradiation and the OS, i- relationship between treatment by radiotherapy and the OS, j- relationship between treatment by surgery and the OS.