Glede na rezultate edinstvene študije globalnega kliničnega preskušanja nekaterim bolnikom z rakom debelega črevesa III. Stopnje, ki so podvrženi kirurški resekciji tumorjev in bezgavk, po kemoterapiji morda ne bo potrebna standardna šestmesečna kemoterapija. V nasprotju s tem pri številnih bolnikih z nizkim tveganjem trimesečna kemoterapija ne poveča znatno stopnje ponovitve raka in lahko prepreči škodljive stranske učinke, vključno z okvaro živcev, ki jo povzroča kemoterapevtsko zdravilo oksaliplatin, ali trajne bolečine, otrplost in mravljinčenje.
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 rak debelega črevesa 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, profesor na Medicinski fakulteti državne univerze Wayne, je dejal, da sem v praksi te nove standarde uporabil pri bolnikih z rakom debelega črevesa z majhnim tveganjem, kar jim prihrani veliko časa zdravljenja in lahko tudi prepreči toksičnost šest mesecev kemoterapevtskega učinka. Približno 400,000 bolnikov po vsem svetu obravnava zdravljenje z oksaliplatinom kot pooperativni kemoterapevtski režim, zato bodo te ugotovitve močno vplivale.
