Comparison of adverse events during 5‐fluorouracil versus 5‐fluorouracil/oxaliplatin adjuvant chemotherapy for stage III colon cancer
BACKGROUND: In clinical trials, combined 5‐fluorouracil (5FU) plus oxaliplatin improves the survival of patients who have resected, stage III colon cancer with manageable toxicity. However, the tolerability of this in the general population of patients with colon cancer is uncertain. METHODS: Advers...
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| Veröffentlicht in: | Cancer 2012-09, Vol.118 (17), p.4309-4320 |
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| container_title | Cancer |
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| creator | Sanoff, Hanna K. Carpenter, William R. Freburger, Janet Li, Ling Chen, Kun Zullig, Leah L. Goldberg, Richard M. Schymura, Maria J. Schrag, Deborah |
| description | BACKGROUND:
In clinical trials, combined 5‐fluorouracil (5FU) plus oxaliplatin improves the survival of patients who have resected, stage III colon cancer with manageable toxicity. However, the tolerability of this in the general population of patients with colon cancer is uncertain.
METHODS:
Adverse outcomes were compared in patients with stage III colon cancer who received either 5FU or 5FU/oxaliplatin within 120 days of undergoing resection versus a control group of patients with stage II colon cancer who did not receive chemotherapy in the Surveillance, Epidemiology, and End Results (SEER)‐Medicare database and in data from the New York State Cancer Registry linked to Medicare and Medicaid. Hospitalizations, emergency room (ER) visits, and outpatient adverse events (AEs) were measured in claims from 30 days to 9 months after patients underwent resection. Multiple logistic regression was used to calculate adjusted odds ratios of events by treatment. Propensity score matching was used to minimize selection bias.
RESULTS:
Adverse outcomes were more frequent for chemotherapy recipients. AE rates were higher in patients who received 5FU/oxaliplatin (81%) compared with patients who received 5FU alone (72%), in the SEER‐Medicare data. The effect of oxaliplatin on AEs was greater in older patients: The odds ratio was 2.10 (95% confidence interval, 1.53‐2.87) for patients aged ≥75 years versus 1.75 (95% confidence interval, 1.39‐2.21) for patients aged |
| doi_str_mv | 10.1002/cncr.27422 |
| format | Article |
| fullrecord | <record><control><sourceid>wiley</sourceid><recordid>TN_cdi_wiley_primary_10_1002_cncr_27422_CNCR27422</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>CNCR27422</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2552-364f4a8c0bb43a5d1990e46a2cba398b7eac6629bbb502586f42c09a44be30cb3</originalsourceid><addsrcrecordid>eNplkMtKAzEUhoMoWKsbnyAvMG2uc1nK4GWgKIiCu-EkzbRT0mRIZqrdue3OZ_RJbKs7V-ecn5_vwIfQNSUTSgibaqfDhGWCsRM0oqTIEkIFO0UjQkieSMHfztFFjKv9mTHJR2hX-nUHoY3eYd9gmG9MiAabjXF9xPMhtG6B5ffnV2MHH_wQQLcWH0pD_JdP_QfYtrPQt26PWg0bcD3WS7P2_dIE6La48QHHHhYGV1WFtbf7vxqcNuESnTVgo7n6m2P0enf7Uj4ks6f7qryZJZpJyRKeikZArolSgoOc06IgRqTAtAJe5CozoNOUFUopSZjM00YwTQoQQhlOtOJjRH-5760127oL7RrCtqakPhisDwbro8G6fCyfjxv_AeOcbHA</addsrcrecordid><sourcetype>Publisher</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Comparison of adverse events during 5‐fluorouracil versus 5‐fluorouracil/oxaliplatin adjuvant chemotherapy for stage III colon cancer</title><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Online Library Free Content</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Sanoff, Hanna K. ; Carpenter, William R. ; Freburger, Janet ; Li, Ling ; Chen, Kun ; Zullig, Leah L. ; Goldberg, Richard M. ; Schymura, Maria J. ; Schrag, Deborah</creator><creatorcontrib>Sanoff, Hanna K. ; Carpenter, William R. ; Freburger, Janet ; Li, Ling ; Chen, Kun ; Zullig, Leah L. ; Goldberg, Richard M. ; Schymura, Maria J. ; Schrag, Deborah</creatorcontrib><description>BACKGROUND:
In clinical trials, combined 5‐fluorouracil (5FU) plus oxaliplatin improves the survival of patients who have resected, stage III colon cancer with manageable toxicity. However, the tolerability of this in the general population of patients with colon cancer is uncertain.
METHODS:
Adverse outcomes were compared in patients with stage III colon cancer who received either 5FU or 5FU/oxaliplatin within 120 days of undergoing resection versus a control group of patients with stage II colon cancer who did not receive chemotherapy in the Surveillance, Epidemiology, and End Results (SEER)‐Medicare database and in data from the New York State Cancer Registry linked to Medicare and Medicaid. Hospitalizations, emergency room (ER) visits, and outpatient adverse events (AEs) were measured in claims from 30 days to 9 months after patients underwent resection. Multiple logistic regression was used to calculate adjusted odds ratios of events by treatment. Propensity score matching was used to minimize selection bias.
RESULTS:
Adverse outcomes were more frequent for chemotherapy recipients. AE rates were higher in patients who received 5FU/oxaliplatin (81%) compared with patients who received 5FU alone (72%), in the SEER‐Medicare data. The effect of oxaliplatin on AEs was greater in older patients: The odds ratio was 2.10 (95% confidence interval, 1.53‐2.87) for patients aged ≥75 years versus 1.75 (95% confidence interval, 1.39‐2.21) for patients aged <75 years. ER use was high in Medicaid patients (83% of those who received chemotherapy), but neither ER use nor hospitalization was increased by oxaliplatin. The 60‐day mortality rate was 1% to 3% for patients who received 5FU alone and 1% to 2% for patients who received combined 5FU/oxaliplatin.
CONCLUSIONS:
The incremental harms of adjuvant chemotherapy with 5FU/oxaliplatin versus 5FU alone were modest in patients with stage III colon cancer who were insured by Medicare and Medicaid. The additional harms in patients aged ≥75 years largely were restricted to outpatient events and did not extend to an increased rate of hospitalization or early death. Cancer 2012. © 2012 American Cancer Society
The addition of oxaliplatin to 5‐fluorouracil‐containing adjuvant therapy for stage III colon cancer increases the rate of outpatient adverse events reported in Medicare/Medicaid billing claims. Oxaliplatin does not increase emergency room use, hospitalization, or early mortality.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.27422</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>adjuvant chemotherapy ; colon cancer ; elderly ; oxaliplatin ; toxicity</subject><ispartof>Cancer, 2012-09, Vol.118 (17), p.4309-4320</ispartof><rights>Copyright © 2012 American Cancer Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2552-364f4a8c0bb43a5d1990e46a2cba398b7eac6629bbb502586f42c09a44be30cb3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.27422$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.27422$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids></links><search><creatorcontrib>Sanoff, Hanna K.</creatorcontrib><creatorcontrib>Carpenter, William R.</creatorcontrib><creatorcontrib>Freburger, Janet</creatorcontrib><creatorcontrib>Li, Ling</creatorcontrib><creatorcontrib>Chen, Kun</creatorcontrib><creatorcontrib>Zullig, Leah L.</creatorcontrib><creatorcontrib>Goldberg, Richard M.</creatorcontrib><creatorcontrib>Schymura, Maria J.</creatorcontrib><creatorcontrib>Schrag, Deborah</creatorcontrib><title>Comparison of adverse events during 5‐fluorouracil versus 5‐fluorouracil/oxaliplatin adjuvant chemotherapy for stage III colon cancer</title><title>Cancer</title><description>BACKGROUND:
In clinical trials, combined 5‐fluorouracil (5FU) plus oxaliplatin improves the survival of patients who have resected, stage III colon cancer with manageable toxicity. However, the tolerability of this in the general population of patients with colon cancer is uncertain.
METHODS:
Adverse outcomes were compared in patients with stage III colon cancer who received either 5FU or 5FU/oxaliplatin within 120 days of undergoing resection versus a control group of patients with stage II colon cancer who did not receive chemotherapy in the Surveillance, Epidemiology, and End Results (SEER)‐Medicare database and in data from the New York State Cancer Registry linked to Medicare and Medicaid. Hospitalizations, emergency room (ER) visits, and outpatient adverse events (AEs) were measured in claims from 30 days to 9 months after patients underwent resection. Multiple logistic regression was used to calculate adjusted odds ratios of events by treatment. Propensity score matching was used to minimize selection bias.
RESULTS:
Adverse outcomes were more frequent for chemotherapy recipients. AE rates were higher in patients who received 5FU/oxaliplatin (81%) compared with patients who received 5FU alone (72%), in the SEER‐Medicare data. The effect of oxaliplatin on AEs was greater in older patients: The odds ratio was 2.10 (95% confidence interval, 1.53‐2.87) for patients aged ≥75 years versus 1.75 (95% confidence interval, 1.39‐2.21) for patients aged <75 years. ER use was high in Medicaid patients (83% of those who received chemotherapy), but neither ER use nor hospitalization was increased by oxaliplatin. The 60‐day mortality rate was 1% to 3% for patients who received 5FU alone and 1% to 2% for patients who received combined 5FU/oxaliplatin.
CONCLUSIONS:
The incremental harms of adjuvant chemotherapy with 5FU/oxaliplatin versus 5FU alone were modest in patients with stage III colon cancer who were insured by Medicare and Medicaid. The additional harms in patients aged ≥75 years largely were restricted to outpatient events and did not extend to an increased rate of hospitalization or early death. Cancer 2012. © 2012 American Cancer Society
The addition of oxaliplatin to 5‐fluorouracil‐containing adjuvant therapy for stage III colon cancer increases the rate of outpatient adverse events reported in Medicare/Medicaid billing claims. Oxaliplatin does not increase emergency room use, hospitalization, or early mortality.</description><subject>adjuvant chemotherapy</subject><subject>colon cancer</subject><subject>elderly</subject><subject>oxaliplatin</subject><subject>toxicity</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNplkMtKAzEUhoMoWKsbnyAvMG2uc1nK4GWgKIiCu-EkzbRT0mRIZqrdue3OZ_RJbKs7V-ecn5_vwIfQNSUTSgibaqfDhGWCsRM0oqTIEkIFO0UjQkieSMHfztFFjKv9mTHJR2hX-nUHoY3eYd9gmG9MiAabjXF9xPMhtG6B5ffnV2MHH_wQQLcWH0pD_JdP_QfYtrPQt26PWg0bcD3WS7P2_dIE6La48QHHHhYGV1WFtbf7vxqcNuESnTVgo7n6m2P0enf7Uj4ks6f7qryZJZpJyRKeikZArolSgoOc06IgRqTAtAJe5CozoNOUFUopSZjM00YwTQoQQhlOtOJjRH-5760127oL7RrCtqakPhisDwbro8G6fCyfjxv_AeOcbHA</recordid><startdate>20120901</startdate><enddate>20120901</enddate><creator>Sanoff, Hanna K.</creator><creator>Carpenter, William R.</creator><creator>Freburger, Janet</creator><creator>Li, Ling</creator><creator>Chen, Kun</creator><creator>Zullig, Leah L.</creator><creator>Goldberg, Richard M.</creator><creator>Schymura, Maria J.</creator><creator>Schrag, Deborah</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><scope/></search><sort><creationdate>20120901</creationdate><title>Comparison of adverse events during 5‐fluorouracil versus 5‐fluorouracil/oxaliplatin adjuvant chemotherapy for stage III colon cancer</title><author>Sanoff, Hanna K. ; Carpenter, William R. ; Freburger, Janet ; Li, Ling ; Chen, Kun ; Zullig, Leah L. ; Goldberg, Richard M. ; Schymura, Maria J. ; Schrag, Deborah</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2552-364f4a8c0bb43a5d1990e46a2cba398b7eac6629bbb502586f42c09a44be30cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>adjuvant chemotherapy</topic><topic>colon cancer</topic><topic>elderly</topic><topic>oxaliplatin</topic><topic>toxicity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sanoff, Hanna K.</creatorcontrib><creatorcontrib>Carpenter, William R.</creatorcontrib><creatorcontrib>Freburger, Janet</creatorcontrib><creatorcontrib>Li, Ling</creatorcontrib><creatorcontrib>Chen, Kun</creatorcontrib><creatorcontrib>Zullig, Leah L.</creatorcontrib><creatorcontrib>Goldberg, Richard M.</creatorcontrib><creatorcontrib>Schymura, Maria J.</creatorcontrib><creatorcontrib>Schrag, Deborah</creatorcontrib><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sanoff, Hanna K.</au><au>Carpenter, William R.</au><au>Freburger, Janet</au><au>Li, Ling</au><au>Chen, Kun</au><au>Zullig, Leah L.</au><au>Goldberg, Richard M.</au><au>Schymura, Maria J.</au><au>Schrag, Deborah</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of adverse events during 5‐fluorouracil versus 5‐fluorouracil/oxaliplatin adjuvant chemotherapy for stage III colon cancer</atitle><jtitle>Cancer</jtitle><date>2012-09-01</date><risdate>2012</risdate><volume>118</volume><issue>17</issue><spage>4309</spage><epage>4320</epage><pages>4309-4320</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>BACKGROUND:
In clinical trials, combined 5‐fluorouracil (5FU) plus oxaliplatin improves the survival of patients who have resected, stage III colon cancer with manageable toxicity. However, the tolerability of this in the general population of patients with colon cancer is uncertain.
METHODS:
Adverse outcomes were compared in patients with stage III colon cancer who received either 5FU or 5FU/oxaliplatin within 120 days of undergoing resection versus a control group of patients with stage II colon cancer who did not receive chemotherapy in the Surveillance, Epidemiology, and End Results (SEER)‐Medicare database and in data from the New York State Cancer Registry linked to Medicare and Medicaid. Hospitalizations, emergency room (ER) visits, and outpatient adverse events (AEs) were measured in claims from 30 days to 9 months after patients underwent resection. Multiple logistic regression was used to calculate adjusted odds ratios of events by treatment. Propensity score matching was used to minimize selection bias.
RESULTS:
Adverse outcomes were more frequent for chemotherapy recipients. AE rates were higher in patients who received 5FU/oxaliplatin (81%) compared with patients who received 5FU alone (72%), in the SEER‐Medicare data. The effect of oxaliplatin on AEs was greater in older patients: The odds ratio was 2.10 (95% confidence interval, 1.53‐2.87) for patients aged ≥75 years versus 1.75 (95% confidence interval, 1.39‐2.21) for patients aged <75 years. ER use was high in Medicaid patients (83% of those who received chemotherapy), but neither ER use nor hospitalization was increased by oxaliplatin. The 60‐day mortality rate was 1% to 3% for patients who received 5FU alone and 1% to 2% for patients who received combined 5FU/oxaliplatin.
CONCLUSIONS:
The incremental harms of adjuvant chemotherapy with 5FU/oxaliplatin versus 5FU alone were modest in patients with stage III colon cancer who were insured by Medicare and Medicaid. The additional harms in patients aged ≥75 years largely were restricted to outpatient events and did not extend to an increased rate of hospitalization or early death. Cancer 2012. © 2012 American Cancer Society
The addition of oxaliplatin to 5‐fluorouracil‐containing adjuvant therapy for stage III colon cancer increases the rate of outpatient adverse events reported in Medicare/Medicaid billing claims. Oxaliplatin does not increase emergency room use, hospitalization, or early mortality.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><doi>10.1002/cncr.27422</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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| source | Wiley Online Library Journals Frontfile Complete; Wiley Online Library Free Content; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | adjuvant chemotherapy colon cancer elderly oxaliplatin toxicity |
| title | Comparison of adverse events during 5‐fluorouracil versus 5‐fluorouracil/oxaliplatin adjuvant chemotherapy for stage III colon cancer |
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