Assessing the Efficacy and Safety of Shorter versus Extended Adjuvant Treatment Duration for Stage III Low-Risk Colon Cancer: A Comparative Analysis

Abstract

Background: In recent years, reducing adjuvant treatment period from 6 months to 3 months in low‐risk stage 3 colon cancer has shown no decline in efficiency and fewer adverse effects, particularly neuropathy. Aim: We examined the efficacy and side effects of 3‐ and 6‐month adjuvant chemotherapy regimens in low‐risk stage 3 colon cancer patients. Methods: Twelve oncology centers retrospectively scanned operated, low‐risk, stage 3 (T1‐3, N1) colon cancer patients. Capecitabine and oxaliplatin (CAPOX) were given to all 3‐month adjuvant chemotherapy patients, while 6‐month patients received FOLFOX orCAPOX. Two adjuvant treatment groups compared DFS (disease‐free survival) and side effects. Results: In total, 204 patients were included in our study and the patients’ median age was 56 years. Regarding treatment duration, 40.6% of patients (n:83) were treated for 3 months and 59.4% (n:121) were treated for 6 months. The 24‐month DFS was numerically high in the 6‐month treatment arm, but the difference was not statistically significant (91% vs 84%, respectively; HR: 0.7 95 CI% 0.3–1.58, p: 0.38). During the treatment time, both in all grades (30% vs 54.5%) and in grade 3 (6% vs 15%), neuropathy was significantly higher in the 6‐month treatment arm. After the end of the treatment, the average persistent neuropathy frequency after 12 months of follow‐up was significantly higher in the 6‐month treatment arm, and all of them were at grade 1–2 (12% vs 31%, respectively). Conclusion: In adjuvant treatment of low-risk stage 3 colon cancer, 3-month CAPOX and 6-month FOLFOX/CAPOX had similar 2-year DFS.The neuropathy was significantly lower in the 3-month treatment arm.