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. 2020 Nov-Dec;34(6):3399-3406.
doi: 10.21873/invivo.12178.

Tolerability and Adverse Events of Adjuvant Chemotherapy for Rectal Cancer in Patients With Diverting Ileostomy

Jun Takahashi  1 , Shingo Tsujinaka  2 , Ryo Maemoto  1 , Yasuyuki Miyakura  1 , Koichi Suzuki  1 , Rintaro Fukuda  1 , Ryotaro Sakio  1 , Erika Machida  1 , Toshiki Rikiyama  1
Affiliations

Tolerability and Adverse Events of Adjuvant Chemotherapy for Rectal Cancer in Patients With Diverting Ileostomy

Jun Takahashi et al. In Vivo. 2020 Nov-Dec.

Abstract

Background/aim: The impact of diverting ileostomy on the feasibility of adjuvant chemotherapy (ACT) remains unclear. We retrospectively investigated the tolerability and adverse events of ACT for rectal cancer in patients with diverting ileostomy.

Patients and methods: Thirty-three patients who received ACT after curative resection with ileostomy construction for rectal cancer were analyzed. We assessed completion rate, the mean relative dose intensities, and the factors affecting the tolerability of ACT.

Results: The completion rate of each chemotherapy regimen was 10 out of 16 patients in oral uracil-tegafur plus leucovorin (UFT/LV), 1 out of 3 patients in oral capecitabine (Capecitabine) and 2 out of 14 patients in capecitabine plus oxaliplatin (CAPOX). The mean relative dose intensities were 77% in UFT/LV, 48% in Capecitabine, and 57% of capecitabine and 42% of oxaliplatin in CAPOX. In multivariate analysis, laparoscopic surgery (Odds ratio=11.6, p=0.021) and receiving preoperative chemoradiotherapy (Odds ratio=32.4, p=0.021) were associated with treatment completion.

Conclusion: Completion rate of ACT in patients with diverting ileostomy was lower than that of colorectal cancer patients in the previous studies. UFT/LV may be a more tolerable regimen than Capecitabine or CAPOX in colorectal cancer patients with diverting ileostomy.

Keywords: Adjuvant chemotherapy; adverse events; ileostomy; rectal cancer; tolerability.

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Conflict of interest statement

The Authors declare no conflicts of interest for this article.

Figures

Figure 1
Figure 1. Percentage of received dose of UFT in each cycle of uracil-tegafur plus leucovorin (UFT/LV) regimen
Figure 2
Figure 2. Percentages of received dose of Capecitabine in each cycle of Capecitabine regimen
Figure 3
Figure 3. (A) Percentages of received dose of Capecitabine in each cycle of capecitabine plus oxaliplatin (CAPOX) regimen. (B) Percentages of received dose of Oxaliplatin in each cycle of capecitabine plus oxaliplatin (CAPOX) regimen
See this image and copyright information in PMC

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References

    1. Matthiessen P, Hallbook O, Rutegard J, Simert G, Sjodahl R. Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: A randomized multicenter trial. Ann Surg. 2007;246(2):207–214. doi: 10.1097/SLA.0b013e3180603024. - DOI - PMC - PubMed
    1. Qu H, Liu Y, Bi DS. Clinical risk factors for anastomotic leakage after laparoscopic anterior resection for rectal cancer: A systematic review and meta-analysis. Surg Endosc. 2015;29(12):3608–3617. doi: 10.1007/s00464-015-4117-x. - DOI - PubMed
    1. Tan WS, Tang CL, Shi L, Eu KW. Meta-analysis of defunctioning stomas in low anterior resection for rectal cancer. Br J Surg. 2009;96(5):462–472. doi: 10.1002/bjs.6594. - DOI - PubMed
    1. Andre T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C, Bonetti A, Clingan P, Bridgewater J, Rivera F, de Gramont A. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the mosaic trial. J Clin Oncol. 2009;27(19):3109–3116. doi: 10.1200/jco.2008.20.6771. - DOI - PubMed
    1. Shimada Y, Hamaguchi T, Mizusawa J, Saito N, Kanemitsu Y, Takiguchi N, Ohue M, Kato T, Takii Y, Sato T, Tomita N, Yamaguchi S, Akaike M, Mishima H, Kubo Y, Nakamura K, Fukuda H, Moriya Y. Randomised phase III trial of adjuvant chemotherapy with oral uracil and tegafur plus leucovorin versus intravenous fluorouracil and levofolinate in patients with stage III colorectal cancer who have undergone japanese D2/D3 lymph node dissection: Final results of JCOG0205. Eur J Cancer. 2014;50(13):2231–2240. doi: 10.1016/j.ejca.2014.05.025. - DOI - PubMed

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