The impact of dose reduction on survival for colon cancer patients treated with adjuvant FOLFOX.
Bibliographic record
Abstract
e14576 Background: Dose reduction (DR) is common during oxaliplatin based treatment for stage III colon cancer. In this study we evaluated the impact of DR of adjuvant FOLFOX chemotherapy on disease free survival (DFS) and overall survival (OS). We also investigated the causes of DR in these patients and evaluated their specific impact on survival. Methods: A multi-center retrospective study was conducted. Patients were included if they had pathologically confirmed and resected stage II or III colon cancer treated with at least one cycle of adjuvant FOLFOX. Chemotherapy dose was calculated using relative dose intensity (RDI). Clinical outcomes were correlated with RDI. Results: One hundred thirty patients treated in Alberta cancer centers between February 2006 and December 2010 were included. The mean age was 60 years, 55% were male and 92% had stage III disease. The incidence of DR was 34% and 55% for 5FU and oxaliplatin, respectively. Median RDI was 0.87 and 0.77 for 5FU and oxaliplatin, respectively. Neuropathy was identified in 105 patients (81%) and was a cause of DR in 40 patients (31%). OS was significantly higher for patients who had neuropathy-related DR (n=40) OS:65.0 months (60.5 , 69.5), compared to patients who had no neuropathy-related DR (n=90) OS:57.2 months (52.7 ,61.7), p-value=0.029. This improvement in OS was only observed in neuropathy patients but DR of any cause did not impact OS (OS 60.5 months for patients with DR versus 54.7 months with no DR, p= 0.10). There was no significant difference in DFS in DR patients (52.5 months) compared to (45.2 month) in patients with no DR, p-value=0.11. Conclusions: Dose reduction of any cause did not impact clinical outcomes of patients treated with adjuvant FOLFOX chemotherapy for resected colon cancer. However, neuropathy induced dose reduction was associated with improved survival in patients treated with adjuvant FOLFOX chemotherapy.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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".