Comparative study: Side effects of Folfox4 and folfiri for colorectal cancer chemotherapy regiment in Margono Soekarjo Hospital, Purwokerto

Abstract

Background: Colorectal carcinoma is one of the most common causes of cancer mortality. Folfox4 (5-FU/leucovorinþOxaliplatin) is a regiment that is used frequently in colorectal carcinoma chemotherapy. The main side effects of folfox4 are nausea-vomitus, diarrhea, neutropenia, sensory neurotoxic, anemia, oral mucositis, as well as the change of transaminase level. Folfiri (5-FU/Leucovorinþirinotecan) has mostly a number of non haematological side effect such as nausea, followed by vomitus, hepatotoxic and diarrhea. We compared the side effects between Folfox4 and Folfiri. Methods: This is a cross-sectional study. The subject were 32 colorectal cancer patients (male and female between 30-60 year old) who had undergone minimal 3 cycle of chemotherapy in Margono Soekarjo Hospital, Purwokerto. Patient(s) were divide into Folfox4 (n ¼ 15) and Folfiri (n ¼ 17), both were given a questioner about side effect of each regimen. Patient(s) who have comorbid other than colorectal cancer were excluded. Results: A total of 32 patients showed average chemotherapy side effects (Folfox4 vs Folfiri; 4.9 vs 6.4). Patient that already had colostomy procedure are 26.7% vs 29.4% (Folfox4 vs Folfiri). The only significant comparison of side effect between 2 groups is malaise (Folfox4 vs Folfiri; 13/15 vs 9/17; p ¼ 0.014; CI ¼ 95%). Other side effect were show no significance differences. The most frequent side effects in Folfiri is hairloss (70.6%), nausea (70.5%), decreased appetite (58.8%), abdominal cramp (58.8%), leg/ arm discomfort (58.8%) and malaise (52,9%). As for Folfox4, the most frequent side effects were malaise (86.7%), decreased appetite (66.7%), abdominal cramps (66.7%), hairloss (46.7%) leg/arm discomfort (46.7%). Conclusions: The comparison between 2 regiments, we can conclud9e that both Folvox4 and Folfiri had similar side effects. Although Folfiri caused more malaise than Folfox4 (p < 0.05). Generally both group had frequent gastrointestinal side effect including nausea, decreased appetite and abdominal pain. Based on this research other than malaise, both group had similar side effect, thus patient who avoid being malaise or disturbed by it should be better to be preferred Folfiri as it had lower malaise risk.