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23375

Low-dose versus Standard-Dose Leucovorin in the Treatment of Colon Cancer: Mansoura University Clinical Experience in Facing the Problem of Leucovorin Shortage

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Last updated: 22 Jan 2023

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Abstract

Background: Drug shortages have become a health care problem worldwide. One of the important drugs that are affected by shortage is leucovorin. It is used with 5-fluorouracil in many protocols for gastro-intestinal tumors and its shortage would have a negative impact on the treatment outcome.
Aim: To compare the effect of low-dose leucovorin versus the standard-dose in the treatment of stage II and III colon cancer.
Methods: The study included 100 patients with stage II or III adenocarcinoma of the colon who presented to the Clinical Oncology Department at Mansoura University Hospital from January 2011 till December 2012 after curative resection and were scheduled to receive adjuvant FOLFOX6 regimen. Patients were randomly allocated to receive standard-dose leucovorin (200 mg/m2, group 1) or low-dose leucovorin (125 mg/m2, group 2), both administered on days 1 and 2 over 2 hours infusion before 5-fluoruracil. The end points were toxicity, disease free survival (DFS) and overall survival (OS).
Results: The two study groups were matched regarding age, sex, and tumor stage. The mean DFS was 48.36 months for group 1 and 49.12 for group 2 with no significant difference (p=0.866). The mean OS was 65.07 months for group 1 and 62.45 for group 2 with no significant difference (p=0.544). Similarly, there was no significant difference between the two groups regarding hematosuppression, diarrhea, mucositis, neurotoxicity and the need for hospitalization.
Conclusion: Both protocols were well tolerated by all patients with no significant difference in the treatment outcome. The use of low-dose leucovorin protocol can help in solving the leucovorin shortage problem.

DOI

10.21608/resoncol.2018.6256.1069

Keywords

Leucovorin, Drug shortage, Colon cancer, FOLFOX

Authors

First Name

Hend

Last Name

Elkalla

MiddleName

M. H. R.

Affiliation

Clinical Oncology and Nuclear Medicine Department, Mansoura University Hospitals, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

dr.hend1113@gmail.com

City

Mansoura

Orcid

0000-0002-6124-7379

First Name

Mohamed

Last Name

Zahi

MiddleName

S.

Affiliation

Clinical Oncology and Nuclear Medicine Department, Mansoura University Hospitals, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

saadmohamed2611@yahoo.com

City

Mansoura

Orcid

0000-0003-0228-8637

First Name

Osama

Last Name

Eldamshety

MiddleName

-

Affiliation

Surgical Oncology, Oncology Center of Mansoura University (OCMU), Faculty of Medicine, Mansoura University, Mansoura, Egypt

Email

dr_osama_82@mans.edu.eg

City

Mansoura

Orcid

-

Volume

15

Article Issue

1

Related Issue

5325

Issue Date

2019-06-01

Receive Date

2018-11-17

Publish Date

2019-06-01

Page Start

15

Page End

19

Print ISSN

2357-0687

Online ISSN

2357-0695

Article File

RESONCOL_Volume 15_Issue 1_Pages 15-19.pdf

PDF . 473.1kB

Link

https://resoncol.journals.ekb.eg/article_23375.html

Detail API

https://resoncol.journals.ekb.eg/service?article_code=23375

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3

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Original Article

Type Code

200

Publication Type

Journal

Publication Title

Research in Oncology

Publication Link

https://resoncol.journals.ekb.eg/

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Article

Created At

22 Jan 2023