Fatigue and weight loss predict survival on circadian chemotherapy for metastatic colorectal cancer

摘要: BACKGROUND: Chemotherapy-induced neutropenia has been associated with prolonged survival selectively in patients on a conventional schedule (combined 5-fluorouracil, leucovorin, and oxaliplatin [FOLFOX2]) but not chronomodulated of the same drugs administered at specific circadian times (chronoFLO4). The authors hypothesized that early occurrence chemotherapyinduced symptoms correlated disruption would hinder efficacy chronotherapy. METHODS: Fatigue weight loss (FWL) were considered to be based previous data. Patients metastatic colorectal cancer (n 5543) from an international phase 3 trial comparing FOLFOX2 chronoFLO4 categorized into 4 subgroups according FWL or other clinically relevant toxicities during initial 2 courses chemotherapy. Multivariate Cox models used assess role toxicity time progression (TTP) overall (OS). RESULTS: proportions comparable both treatment arms (P 5.77). No was TTP OS FOLFOX2. median ranged 16.4 (95% confidence limits [CL], 7.2-25.6 months) 19.8 months CL, 17.722.0 subgroup 5.45). Conversely, FWL, no toxicity, independently predicted for significantly shorter <.0001) 5.001) chronoFLO4. 13.8 10.4-17.2 21.1 19.0-23.1 presence absence chemotherapy-induced respectively. CONCLUSIONS: Early onset independent predictor poor only Dynamic monitoring detect could allow optimization rapid chronotherapy concomitant improvements safety efficacy. Cancer 2013;119:2564-73. V C 2013 American Society.