Adjuvant treatment in patients with stage III colon cancer is recommended for 12 cycles, every 2 weeks. The recommended dose schedule given every two weeks is as follows:
Day 1: Oxaliplatin 85 mg/m² IV infusion in 250-500 mL D5W and leucovorin 200 mg/m² IV infusion in D5W both given over 120 minutes at the same time in separate bags using a Y-line, followed by 5-FU 400 mg/m² IV bolus given over 2–4 minutes, followed by 5-FU 600 mg/m² IV infusion in 500 mL D5W (recommended) as a 22-hour continuous infusion.
Day 2: Leucovorin 200 mg/m² IV infusion over 120 minutes, followed by 5-FU 400 mg/m² IV bolus given over 2–4 minutes, followed by 5-FU 600 mg/m² IV infusion in 500 mL D5W (recommended) as a 22-hour continuous infusion.
|Oxaliplatin||85 mg/m²||IV infusion||2 h||day 1|
|Folinic acid||200 mg/m²||IV infusion||2 h||day 1 + 2|
|Fluorouracil||400 mg/m²||IV bolus||2 min||day 1 + 2|
|Fluorouracil||600 mg/m²||IV infusion||22 h||day 1 + 2|
Premedication with antiemetics, including 5-HT3 blockers with or without dexamethasone, is recommended.
The dose schedule given every two weeks is as follows:
Day 1–2: Oxaliplatin 100 mg/m² IV infusion, given as a 120 minutes IV infusion in 500 mL D5W, concurrent with leucovorin 400 mg/m² (or levoleucovorin 200 mg/m²) IV infusion, followed by 5-FU 400 mg/m² IV bolus, followed by 46-hour 5-FU infusion (2400 mg/m² for first two cycles, increased to 3000 mg/m² in case of no toxicity > grade 1 during the first two cycles).
Days 3–14: Rest days
Antiemetic prophylaxis with 5-HT3-receptor antagonist.
- Cancer Research UK, CancerHelp UK
- de Gramont A, Figer A, Seymour M, Homerin M, Hmissi A, Cassidy J, Boni C, Cortes-Funes H, Cervantes A, Freyer G, Papamichael D, Le Bail N, Louvet C, Hendler D, de Braud F, Wilson C, Morvan F, Bonetti A (2000). "Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer". J Clin Oncol 18 (16): 2938–47. PMID 10944126. HTML PDF Patients with advanced colorectal cancer were given 5-fluorouracil and leukovorin. Those who were also given oxaliplatin were more likely to have a response, and had longer progression-free survival, than patients without oxaliplatin. However, patients with oxaliplatin didn't survive any longer than patients without it.
- FDA Approval: Eloxatin [oxaliplatin] PDF
- Tournigand, Christophe; André, Thierry; Achille, Emmanuel; Lledo, Gérard; Flesh, Michel; Mery-Mignard, Dominique; Quinaux, Emmanuel; Couteau, Corinne; Buyse, Marc (2004). "FOLFIRI Followed by FOLFOX6 or the Reverse Sequence in Advanced Colorectal Cancer: A Randomized GERCOR Study". Journal of Clinical Oncology 22 (2): 229–237. doi:10.1200/JCO.2004.05.113. ISSN 0732-183X. PMID 14657227.
- Goldberg R, Sargent D, Morton R, Fuchs C, Ramanathan R, Williamson S, Findlay B, Pitot H, Alberts S (2004). "A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer". J Clin Oncol 22 (1): 23–30. doi:10.1200/JCO.2004.09.046. PMID 14665611.
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