Retrospective analysis of dose intensity, toxicity, and clinical outcomes in 5-fluorouracil (5FU)-based regimens in adjuvant treatment of colon cancer.
Bibliographic record
Abstract
e14575 Background: Adjuvant colon cancer treatment relies on 5FU containing regimens as either an IV formulation or as the oral pro-drug, capecitabine, combined with oxaliplatin (FOLFOX6 and CAPOX). We performed a retrospective chart review comparing average relative dose intensity (ARDI), overall survival (OS), disease free survival (DFS), and toxicity profiles of these two regimens. Methods: 233 patients between January 1, 2006 and December 31, 2011 received chemotherapy combining either FOLFOX6 (n= 128) or CAPOX (n=105) in Edmonton, Alberta. ARDI was compared by calculating a percent of target dose achieved in the average cycle for each patient. Data on OS, DFS, baseline demographics, and toxicities were gathered. Survival data was plotted using the Kaplan-Meier method and compared using the log-rank test. Variable comparisons were performed with the Student’s t-test or the Fisher’s Exact test. Follow up was complete until November 1, 2012. Results: Oxaliplatin ARDI was significantly lower in those treated with CAPOX compared to FOLFOX6 (80.72% vs 87.11%, p=0.0033), as was the 5-FU component (87.10% vs 93.60%, p<0.0001). More patients treated with CAPOX had dose limiting toxicities (84.76% vs 73.40%, p=0.039), and there were significantly more Grade 2 and higher toxicities in those on CAPOX (p<0.0001). A similar percentage of goal number of cycles was achieved between CAPOX and FOLFOX6 (87.38% vs 91.80%, p=0.13) and similar neuropathy was noted between groups. Survival analysis demonstrated similar OS and trends towards improved DFS with CAPOX (1 year – 89.55% vs 83.20%, 3 year – 67.13% vs 58.01%, p=0.051). Stage specific analysis showed stage III patients had improved DFS with CAPOX (1 year – 93.36% vs 86.69%, 3 year- 71.58% vs 68.10%, p=0.042) and trends towards improved OS with CAPOX (1 year – 100% vs 95.56%, 3 year – 95.08% vs 80.17%, p=0.16). The groups had similar age, gender, tumor size, and node status, while ECOG was slightly higher with FOLFOX6 (0.589 vs 0.419, p=0.0315). Conclusions: While patients on CAPOX had significantly lower doses of oxaliplatin and the 5-FU component of their treatment they appear to have improved outcomes compared to FOLFOX6.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".