Retrospective Analysis of the Safety of FOLFOX Compared to CAPOX for Adjuvant Treatment of Stage III Colorectal Cancer in Newfoundland Patients
Bibliographic record
Abstract
Background: Capecitabine and oxaliplatin (CAPOX) and infusional 5-fluouracil, folinic acid, and oxaliplatin (FOLFOX) are the two chemotherapy regimens in current clinical use for the adjuvant treatment of colorectal cancer (CRC). Many centers in Newfoundland lack the resources to support the home infusion program required for FOLFOX, leaving CAPOX as the sole treatment option. This study aimed to review if Newfoundland patients receiving CAPOX experience greater treatment-induced toxicities. Methods: A multicenter retrospective cohort study of 93 Stage III CRC patients. The frequency and severity of toxicities, healthcare resource utilization, and treatment completion rates were compared between the two treatment options. Results: Grade 3 diarrhea and grade 1 or 2 nausea/vomiting were more common in CAPOX compared to FOLFOX-treated patients (26.9% versus 2.99%, p = 0.002; 61.5% versus 31.8%; p = 0.048, respectively). Grade 1 or 2 mucositis was more common with FOLFOX (35.8% versus 3.9%, p = 0.002). CAPOX was associated with higher rates of severe toxicity (53.9% versus 25.4%, p = 0.009), while rates of grade 1 and 2 toxicities were not significantly different between groups. CAPOX-treated patients were greater than twice as likely to require emergency department treatment secondary to toxicity (mean 0.692 visits per patient versus 0.313 in FOLFOX patients, p < 0.001) and the proportion of patients that were hospitalized secondary to CAPOX toxicity was greater. Significantly more FOLFOX patients were able to finish their prescribed treatment plans compared to CAPOX patients (89.5% versus 53.8%; p < 0.001). Conclusions: Compared to FOLFOX-treated patients, CAPOX patients are more likely to experience toxicities of greater severity, require emergency services secondary to treatment-related toxicity, and to discontinue therapy. This reflects a reduced standard of care that may decrease patient safety and quality of life.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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) | 0.000 | 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 teacher head, 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".