Colorectal cancer does not require complete chemotherapy after 6 months

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According to the results of a unique global clinical trial study, some patients with stage III colon cancer who undergo surgical resection of their tumors and lymph nodes may not require standard six-month chemotherapy after chemotherapy. In contrast, for many low-risk patients, three months of chemotherapy does not significantly increase the rate of cancer recurrence and can prevent harmful side effects, including nerve damage caused by the chemotherapy drug oxaliplatin, or permanent pain, numbness and tingling .

This is a global trial launched in 2007 on the International Duration Assessment of Adjuvant Chemotherapy (IDEA). Six parallel Phase III trials in 12 countries in North America, Europe and Asia enrolled 12,834 eligible patients. Patients with stage III colon cancer usually use FOLFOX or CAPOX chemotherapy for standard treatment after surgery. The researchers randomly assigned patients to treatment groups of three or six months.

Results: Three months of chemotherapy is not suitable for all patients. Instead, the data shows that the duration of chemotherapy should be determined based on the combination of drugs used and the individual characteristics of the patient ’s cancer: the degree of tumor deposition on the colon wall and the number of lymph nodes that the cancer has spread to. For low-risk patients-those with shallow tumors and affected lymph nodes-treatment with CAPOX for 3 months has been shown to be safe and effective, with little side effects, the same as the progression-free survival (PFS) of six months of treatment. However, in some cases, a six-month course of treatment is better for high-risk patients.

Dr. Anthony Shields, a professor at Wayne State University School of Medicine, said that in practice, I have applied these new standards to patients with low-risk colon cancer, which saves them a lot of treatment time and can also prevent the toxicity of six months of chemotherapy effect. About 400,000 patients worldwide consider oxaliplatin-based treatment as a postoperative chemotherapy regimen, so these findings will have a huge impact.

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