Utilization of capecitabine-oxaliplatin (CAPOX) versus infusional 5-fluorouracil and oxaliplatin (FFOX) in the adjuvant treatment (AT) of resected high-risk colon cancer.
Bibliographic record
Abstract
e14696 Background: Patients with high-risk Stage II or Stage III colon cancer are candidates for adjuvant chemotherapy with CAPOX or mFOLFOX6. Our primary outcome was to identify the utilization rates and review the patient characteristics, dose-delivery and toxicities associated with both protocols. Methods: All patients receiving adjuvant CAPOX or FFOX (given as mFOLFOX6) for Stage II or Stage III colon cancer from October 1st, 2011 to January 1st, 2014 were identified using the provincial pharmacy database of the BC Cancer Agency. Data was collected from electronic patient health records and pharmacy database. Patient demographics, treatment site, co-morbidities, stage, treatment, dose-limiting toxicities (DLTs) and the total number of completed cycles were collected. Results: 315 patients were eligible for inclusion, 87% with stage III disease. 218 patients (69%) received FFOX, while 97 patients (31%) received CAPOX. Patients assigned to CAPOX were significantly younger (age < = 50y: 29% vs 11%; p = 0.022), were more frequently working (48% vs 38%, p = 0.19), and were less likely to require a central line (10% vs 100%). More patients on CAPOX experienced DLTs (95% vs 81%, p = 0.004). The most common DLTs included peripheral neuropathy (38% CAPOX vs 42% FFOX, p = 0.66), diarrhea (32% CAPOX vs 11% FFOX, p = 0.0004), neutropenia (7% CAPOX vs 28% FFOX, p < 0.0001), fatigue (16% CAPOX vs 11% FFOX, p = 0.41), hand-foot syndrome (16% CAPOX vs 3% FFOX, p = 0.003), nausea/emesis (10% CAPOX vs 5% FFOX, p = 0.28), and mucositis (1% CAPOX vs 11% FFOX, p = 0.004). 77% of patients on FFOX completed the planned number of cycles versus 64% on CAPOX (p = 0.045). Conclusions: In this contemporary, population-based cohort of patients with resected colon cancer, CAPOX was less commonly prescribed, with only 31% of patients receiving CAPOX. Overall, DLTs were more common with CAPOX with significantly more diarrhea and hand-foot syndrome, but less neutropenia and mucositis. Despite the perceived convenience of CAPOX, FFOX is the preferred AT regimen in practice, and is associated with significantly higher rates of treatment completion.
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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 | 0.000 | 0.001 |
| 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".