Preview

Medical alphabet

Advanced search

Possibilities for reducing toxicity in colon cancer patients receiving adjuvant polychemotherapy

https://doi.org/10.33667/2078-5631-2023-17-65-72

Abstract

Introduction. According to the World Health Organization, colorectal cancer is the third most common type of cancer in the world. The surgical method of treatment is the main one in locally advanced stages; however, a large proportion of patients require complex treatment, including adjuvant chemotherapy. When conducting adjuvant chemotherapy, it is extremely important to maintain the rhythm of cycles and minimize adverse events that may lead to dose reduction. Prevention of dose-limiting toxicity allows us to achieve the following goals – improving the quality of life of the patient and adherence to treatment, as well as performing a full-fledged stage of the planned complex treatment.

Aim. Evaluation of the effectiveness of Polisorb MP in the occurrence of gastrointestinal side effects of adjuvant polychemotherapy in patients with colorectal cancer.

Materials and methods. The prospective study included 40 patients with a verified diagnosis of CCR, received treatment and observation at the St. Petersburg City Clinical Oncology Centre from April 2022 to October 2022. All patients received radical surgery and subsequent adjuvant chemotherapy in the XELOX regimen were divided into two groups. The first group of patients (n = 20) received only ACT, patients of group 2 from 16 to 20 days after the completion of each session of ACT received Polysorb MP. Both groups were comparable in terms of gender and age. In the studied cohort of patients there were 20 (50.0 %) men and 20 (50.0 %) women. The age of patients ranged from 31 to 75 years; the median age was 62 years [54.00–68.50]. The quality of life of patients receiving adjuvant polychemotherapy was assessed using the QLQ-C30 questionnaires with the QLQ-CR29, EQ-5D module.

Results. The use of Polysorb MP made it possible to significantly reduce the level of creatinine in the blood of patients, which can increase after one cycle of ACT, especially with the use of platinum preparations. In addition, our results indicate that the use of Polysorb MP after ACT in patients with colorectal cancer can significantly improve the quality of life of patients, both by minimizing the symptoms associated with previous treatment and the adverse effects of the drug treatment itself, as well as by improving the general condition of the patient. In patients who received Polysorb MP as an accompanying therapy against the background of AHT, significant deterioration in general and functional health (according to the results of the analysis of the QLQ-C30 questionnaires), increased severity of disease symptoms and treatment complications (according to the results of the analysis of the QLQ-C29 and QLQ-C30 questionnaires), as well as a significant decrease in the general state of health according to the results of the analysis of the dynamics on the EQ-5D scale, was not detected.

Conclusions. In patients receiving adjuvant polychemotherapy for locally advanced colon cancer, it can be concluded that it is advisable to use Polysorb MP in order to reduce the manifestation of gastrointestinal toxicity and improve the quality of life of patients, which, in turn, allows a full course of treatment, avoiding dose-limiting adverse events.

About the Authors

R. V. Orlova
Saint Petersburg State University; City Clinical Oncology Centre
Russian Federation

Orlova Rashida V., DM Sci (habil.), head of Dept of Oncology; chief specialist in clinical oncology

Author ID: 401170

Saint Petersburg



E. E. Topuzov
City Clinical Oncology Centre; North-Western State Medical University n. a. I. I. Mechnikov
Russian Federation

Topuzov Eldar E., DM Sci (habil.), chief physician; head of Dept of Surgery n. a. V. A. Oppel

eLibrary SPIN-код 1065–4191

Author ID: 453185

Saint Petersburg



A. A. Varankina
City Clinical Oncology Centre
Russian Federation

Varankina Anna A., medical oncologist of Cancer Drug Therapy (Chemotherapeutic) Dept No. 10

Saint Petersburg



A. V. Androsova
Saint Petersburg State University; City Clinical Oncology Centre
Russian Federation

Androsova Aleksandra V., post-graduate student; medical oncologist of Cancer Drug Therapy (Chemotherapeutic) Dept No. 10

Saint Petersburg



N. P. Belyak
Saint Petersburg State University; City Clinical Oncology Centre
Russian Federation

Belyak Natalia P., PhD Med, associate professor at Dept of Oncology; head of Cancer Drug Therapy (Chemotherapeutic) Dept No. 10

Author ID: 778562

Saint Petersburg



A. K. Ivanova
City Clinical Oncology Centre
Russian Federation

Ivanova Anastasia K., PhD Med, medical oncologist of Cancer Drug Therapy (Chemotherapeutic) Dept No. 11

Saint Petersburg



S. I. Kutukova
City Clinical Oncology Centre; First Saint Petersburg State Medical University n. a. academician I. P. Pavlov
Russian Federation

Kutukova Svetlana I., DM Sci (habil.), professor at Dept of Maxillofacial Surgery; associate professor at Dept of Oncology; medical oncologist of Cancer Drug Therapy (Chemotherapeutic) Dept No. 10

Author ID: 698363

Saint Petersburg



References

1. Malignant neoplasms in Russia in 2019 (morbidity and mortality). Ed. A. D. Kaprin, V. V. Starinsky, A. O. Shakhzadova. Moscow Research Institute n. a. P. A. Herzen – a Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russia, 2020. 252 p.

2. Raskov H., Pommergaard H. C., Burcharth J., Rosenberg J. Colorectal carcinogenesis – update and perspectives. World J Gastroenterol. 2014; 20: 18151–64.

3. Brandi G., De Lorenzo S., Nannini M. et al. Adjuvant chemotherapy for resected colorectal cancer metastases: Literature review and meta-analysis. World J Gastroenterol 2016; 22 (2): 519.

4. Iveson T., Sobrero A. F., Yoshino T. et al. Prospective pooled analysis of four randomized trials investigating duration of adjuvant (adj) oxaliplatin-based therapy (3 vs 6 months for patients (pts) with high-risk stage II colorectal cancer (CC). J Clin Oncol 2019; (Suppl.): 3501.

5. Fedyanin M. Yu. Modern clinical and molecular biological platform for the treatment of patients with colon cancer: Dis. … DM Sci. M., 2018. 414 p.

6. Grothey A., Sobrero A. F., Shields A. F. et al. Duration of adjuvant chemotherapy for stage III colon cancer. N Engl J Med 2018; 378: 1177–88.

7. Hudita A, Radu IC, Galateanu B, Ginghina O, Herman H, Balta C, Rosu M, Zaharia C, Costache M, Tanasa E, Velonia K, Tsatsakis A, Hermenean A. Bioinspired silk fibroin nano-delivery systems protect against 5-FU induced gastrointestinal mucositis in a mouse model and display antitumor effects on HT-29 colorectal cancer cells in vitro. Nanotoxicology. 2021 Sep; 15 (7): 973–994. DOI: 10.1080/17435390.2021.1943032. Epub 2021 Jul 2. PMID: 34213984.

8. Belyakov N. A. Enterosorption (introduction to the problem). N. A. Belyakov, A. V. Solomennikov. L., 1990. 35 p.

9. Enterosorption. Ed. prof. N. A. Belyakov. Center for sorption technology. L., 1991. 325 p.

10. Enterosorption: State of the art and prospects for the future. V. G. Nikolaev [et al.]. Herald of Problems of Biology and Medicine. 2007. Issue 4. P. 7–17.

11. Panfilova V. N., Taranushenko T. E. Application of enterosorbents in clinical practice. Pediatric pharmacology. 2012;9(6):34–39. (In Russ.) https://doi.org/10.15690/pf.v9i6.516.

12. Chirkova M. V., Gulyaev D. K., Chugunova M. P., Belonogova V. D. Development of a solid dosage form with adsorption activity. Pharmacy & Pharmacology. 2020;8(4):233–241. https://doi.org/10.19163/2307–9266–2020–8–4–233–241

13. Medical chemistry and clinical applications of silicon dioxide. Ed. A. A. Chuiko. Kyiv: Scientific Thought, 2003. 415 p.

14. Kalev O. F., Korobkin A. V., Zakharova M. N. Polysorb MP in enteropathy and manifestations of chemotherapy toxicity in patients with acute myeloid leukemia. Physician. 2007. No. 10. P. 46–48.

15. Zotov P. B., Chernetsova L. F. Polysorb MP in palliative therapy of cancer patients. Tyumen Medical Journal. 2000. No. 2.


Review

For citations:


Orlova R.V., Topuzov E.E., Varankina A.A., Androsova A.V., Belyak N.P., Ivanova A.K., Kutukova S.I. Possibilities for reducing toxicity in colon cancer patients receiving adjuvant polychemotherapy. Medical alphabet. 2023;(17):65-72. (In Russ.) https://doi.org/10.33667/2078-5631-2023-17-65-72

Views: 249


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2078-5631 (Print)
ISSN 2949-2807 (Online)