NEJM: The halving of chemotherapy time does not affect patient survival and significantly reduces side effects!

The magnitude of chemotherapy's side effects on cancer patients need not be said at all, although patients diagnosed with the tumor have already been destroyed by chemotherapy after surgeryAnd the painful experience sway during chemotherapy, such as vomiting, dizziness and so on, many patients can not stand not only from the heart resistance but also from the action often in the course of chemotherapy calls for the interruption of chemotherapyThe same is true for colon cancer patients, especially stage 3 patients, whose chemotherapy is based primarily on a drug called oshariplatin .)One is called three drugs, including fluorolysine, calcium folate, and oshariplatin, and the other is called carperabine and oshariplatinThe molecular formula (left) of oshariplatin (left) and the drug (pictured adapted from the network) for a month of programmes (fluoruric iasin, folate acid and oshariplatin) or programmes (carperatabine and o'saliplatin) became standard complementary treatments for stage III colon cancerThe risk of sensory neurotoxicity of oshari platinum depends on the cumulative doseIts neurotoxicity usually peaks months after the last drug, making it difficult to individually experience medicationsIts toxicity can be severe and the long-term effects on the daily life of patients after treatment may persist throughout life in all patients who receive oshari platinum chemotherapy with varying degrees of neurotoxicityThe neurotoxicity caused by oshari platinum is mainly divided into types: acute neurotoxicity and chronic neurotoxicityAcute neurotoxicity usually occurs at lower cumulative doses, mainly in the form of acute hand and foot numbness that often triggers or worsens when exposed to cold objectsIt usually occurs within a few hours of oshariplatin treatment and a full recovery hours or days after the end of treatmentChronic neurotoxicity is often associated with dose accumulation of o'Sullivan, which can cause numbness in the hands and feet for months or even years and cause dysfunction of the nervous systemSevere chronic neurotoxicity significantly reduces the quality of life or even life-threatening in patientsClinically, it is common to see many patients refuse to continue chemotherapy due to chronic neurotoxicity, which makes chemotherapy effectiveIs there any way to reduce the side effects of chemotherapy when o's sharpcane can cause great toxicity to nerves (pictured) Although the development of medicine has accumulated some methods but not particularly useful better methods may also be using other more accurate targeted therapy methods to reduce the side effects of compound drugs or reduce the time of chemotherapy After all, chemotherapy drugs not only kill tumor cells their damage to normal cellular tissue will soon appearSo reducing the amount of time for chemotherapy is a pretty good option for controlling side effectsThe key issue, however, is to reduce the time of chemotherapy although the side effects are less but the patient's survival time is less meaningful because, as the saying goes, "is the drug three-cents" in general, the drug is bound to cause harm to the body but clearly know that it will hurt the body but in order to maintain life has to eatSo the best result is that the time of chemotherapy is reduced while the survival time is not affectedThe researchers' article in the prestigious medical journal New England Journal is what a team of researchers from leading cancer institutions such as Mayo Clinical Center wants to exploreA recent clinical study in the New England Journal of medicine included more than 10,000 colon cancer patients in the country and found that halving the duration of chemotherapy did not affect patients' survival and reduced chemotherapy time significantly reduced side effectsThe researchers conducted a forward-looking preset summary analysis of the simultaneous phase randomized trials, which were all non-essential studies that compared months and months (fluorourery, folate and oshariplatin) or (Kaperitabin and Oshariplatin) as an auxiliary therapyThe main endpoint is the annual disease-free survival rateIf the upper limit of the two-sided confidence interval of the risk ratio is not exceeded, it is determined that the monthly treatment is not inferior to that of the monthThe results showed that the phase trial spent in the group of patients with stage III colon cancer from year to yearThe cases meet the criteria of improved intentional therapy analysisThe table lists the patient characteristics in each trial and intentional treatment analysisAlthough the characteristics and tumor conditions of patients are mostly similar, there are some significant differences between the trialsThe proportion of patients with stage tumors (tumors penetrating the surface of the peritoneal layer or adhesion to adjacent organs) varies from () to ()The proportion of patients with period (sic) varies from (French trial) to ()The most important thing to note is that usage is significantly differentAlthough only used and accepted only by the only patients in the French trial, most patients in () and () were usedOverall about the patients received by the patientThe supplemental appendix table lists patient characteristics and tumor status by treatment group The median follow-up period at the data cut-off time (year and month) ranges from month () to month () Each test provides for its own follow-up period The study after the recurrence or death of the disease in the case of a single case failed to confirm in the overall study population that the monthly treatment was not inferior to the monthly treatment (risk ratio; confidence interval Treatment (;) and treatment (;; s) only the former meet the non-inferior efficacy standard after shortening the time An exploratory analysis of all therapies found that: or the monthly treatment of patients is not inferior to the monthly treatment of the annual survival rate of the disease is and (; , and, in the middle month of the patient's treatment, the survival rate of disease-free treatment is better than the monthly treatment (; The survival rates of patients with colon cancer patients with chemotherapy duration of three months and six months did not differ significantly (pictured from) and the expected same month treatment group's therapeutic compliance (i.e the proportion of patients receiving all planned treatment) was lower than that of the monthly treatment group (table) The monthly group were used on average with the combined fluorouretin and capedabine planned doses, and the proportion was the sum of the monthgroup The monthly group and the user spent an average of the planned dose of oshari platinum, and the ratio was sum in the monthgroup The researchers found that reducing the duration of chemotherapy from a standard month to half a month did not affect the survival rate of colon cancer patients This has to be said to be exciting news The result means that you've been on chemotherapy for three months as long as you've had a month of chemotherapy So who's going to lose six months of drugs? Three more months of sin! So it's a pleasure to say that The researchers then compared the survival data for three and six months of chemotherapy in colon cancer patients at different stages Further comparison of chemotherapy duration sat in the colon cancer at different periods of time, the three-year survival rate of three-month and six-month chemotherapy with the program or the program did not significantly differ (pictured from) The researchers further found that neither the commonly used programme for colon cancer or the program of three months and six months of chemotherapy three-year survival rate did not significantly differ And the three-year survival rate of patients who were in different stages of tumor progression for a period of time did not differ significantly from that of chemotherapy months In short, the survival rate of patients with two common chemotherapy regimens for colon cancer is almost the same But the safety aspect of the month of chemotherapy regimen is much better than the monthly programme The results showed that the rate of adverse events in the short-term auxiliary treatment group was significantly lower than in the long-term treatment group and not related to chemotherapy protocol (table and supplementary appendix) The incidence of intermediate and above neurotoxicity in the treatment group during and after the end of treatment was significantly lower than that of the monthly treatment group (monthly treatment month treatment treatment) In addition, the incidence of diarrhea, neutrophil reduction, platelet reduction, nausea, mucositis, fatigue and hand-foot syndrome was much lower in the treatment group Further researchers analyzed different subgroups and found that monthly therapy was better than monthly therapy in the users (; The annual disease-free survival rate of the monthly group was higher than that of the monthly group when the overall analysis of all staging patients was higher ( ) However, the patient-free survival rate of the patient's medium-month treatment compared with the month treatment reached the pre-set non-poor efficacy determination value The annual disease-free survival rate of the month sat and the month of treatment was the same, respectively The results of the interaction test by treatment group ingested were highly significant (figure) after multiple comparison correction The proportion of patients with period sickness was higher than that of the user, but there was no significant difference in the number of lymph nodes, sex, and the number of lymph nodes examined Also in patients (positive lymph nodes) (;; There was no significant interaction (interaction) between the duration of treatment and the staging The effect spent on short-term treatment time on low-risk patients (or with such patients) and high-risk patients (or such patients) was not worse than the monthly treatment in low-risk patients (; The high-risk patients received the effect of monthly treatment is better (; Be aware that there is no significant interaction (interaction) between the treatment time and the risk group, as the months of chemotherapy drugs described above and the final survival time of the month's chemotherapy drugs Not only less money consumption, mental torture is the key is also to reduce the damage of chemotherapy drugs to the body to improve the quality of life "As a result of this new study, we can now confidently shorten the length of chemotherapy in patients, which will significantly reduce the side effects of treatment." Professor Dr Ukatology' gastrointestinal cancer specialist, funded by Cancer Research UK, said: "This study shows that this is a question that is important to patients and that doctors around the world work together to get the answer This is a huge achievement "The study concludes that studies in patients with stage III colon cancer who received or assisted treatment did not prove that monthly treatment was inferior to monthly treatment, " the study concluded However, specific treatment patterns and risk clusters have had a significant impact on the results The effect of the patient's medium-month treatment and the month sized were quite significant especially in the low-risk subgroup In patients treated with a higher rate of disease-free survival, especially in the high-risk subgroup These results suggest that specific options, duration of treatment, patient characteristics, and significant risks of increased toxicity due to long-term use of oshari platinum regimens should be weighed against treatment, including persistent neurotoxicity