title: Adjuvant FOLFOX treatment for stage III colon cancer: how many cycles are enough?
abstract: OBJECTIVE
  Adjuvant FOLFOX (5-fluorouracil and oxaliplatin) chemotherapy benefits stage III colon cancer patients. However, it still results in side effects and increased cost. Reducing cycles had been thought to decrease these problems. This retrospective study aimed to find the appropriate number of treatment cycles that are sufficient for treating these patients.
  
  
  METHODS
  A total of 213 stage III colon cancer patients receiving adjuvant FOLFOX therapy were retrospectively recruited. Demographic data were collected for analysis. Survival analyses were performed between all cases of patients receiving above and below a certain cycle number. If a significant difference was reached at that cycle number, multivariate Cox Regression was performed with those factors resulting in p < 0.2 to assess the independent prognostic factors.
  
  
  RESULTS
  The 5-year overall survival rate of patients was 77.9 %, and the 3-year disease-free survival was 76.7 %. For overall survival, a significant benefit was noted for treatment of at least 8 cycles, for disease-free survival, significant differences were apparent from patient data of those who underwent from 7 to 12 treatment cycles. Multivariate survival analysis of that patient data at cycle 8 for overall survival and cycle 7 for disease free survival revealed cycle number as the only independent prognostic factor (p = 0.04, 0.048).
  
  
  CONCLUSIONS
  Cycle number of adjuvant FOLFOX is a significant prognostic factor for stage III colon cancer patients. At least 8 cycles are needed to have an overall survival benefit, and 7 to disease-free survival.
authors: Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No 201,Sec 2, Shih-Pai Rd, Taipei, 11217 Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Yi-Jian
authors: YJ
authors: Tsai
authors: Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No 201,Sec 2, Shih-Pai Rd, Taipei, 11217 Taiwan.
authors: Jen-Kou
authors: JK
authors: Lin
authors: Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No 201,Sec 2, Shih-Pai Rd, Taipei, 11217 Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Wei-Shone
authors: WS
authors: Chen
authors: Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No 201,Sec 2, Shih-Pai Rd, Taipei, 11217 Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Jeng-Kai
authors: JK
authors: Jiang
authors: School of Medicine, National Yang-Ming University, Taipei, Taiwan ; Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Hao-Wei
authors: HW
authors: Teng
authors: School of Medicine, National Yang-Ming University, Taipei, Taiwan ; Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Chueh-Chuan
authors: CC
authors: Yen
authors: Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No 201,Sec 2, Shih-Pai Rd, Taipei, 11217 Taiwan.
authors: Tzu-Chen
authors: TC
authors: Lin
authors: Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No 201,Sec 2, Shih-Pai Rd, Taipei, 11217 Taiwan ; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Shung-Haur
authors: SH
authors: Yang
keywords: Adjuvant chemotherapy; Colon cancer; FOLFOX; Oxaliplatin