Profile of Chemotherapeutic Treatment of Patients with Colorectal Cancer in a Hospital in Rio de Janeiro, Brazil

Pereira, Eduardo Rodrigues; Sobreira-da-Silva, Mario Jorge

doi:10.32635/2176-9745.RBC.2025v71n3.5223

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Original Article • Rev. Bras. Cancerol. 71 (3) • 2025 • https://doi.org/10.32635/2176-9745.RBC.2025v71n3.5223EN linkcopy

Profile of Chemotherapeutic Treatment of Patients with Colorectal Cancer in a Hospital in Rio de Janeiro, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction: Colorectal cancer is one of the leading causes of cancer-related death. Differences can be observed in relation to chemotherapy treatment when comparing guidelines from the Brazilian Ministry of Health with those of scientific societies. In this context, real-world data studies may provide evidences regarding the necessity of adjustments of the currently used regimens.

Objective: To identify the chemotherapy treatment profile of patients with colorectal cancer in an oncology hospital.

Method: The study was conducted with data obtained from physical or electronic charts, histopathological test results, and chemotherapy prescriptions. The variables were grouped into three categories: sociodemographic, clinical, and treatment. Overall survival at 24 months was estimated using the Kaplan-Meier method.

Results: The combined regimen of capecitabine and oxaliplatin was the most prescribed, being used for all therapeutic purposes. Neoadjuvant regimens associated with radiotherapy were exclusively for rectal cancer. The combination of fluorouracil and folinic acid was used as adjuvant therapy, and regimens containing irinotecan had palliative purpose. The overall survival at 24 months was 83.8% for neoadjuvant treatment, 86.8% for adjuvant treatment, and 44.3% for palliative treatment.

Conclusion: The therapeutic regimens identified are aligned with those recommended by the guidelines of the Brazilian Ministry of Health. Most patients were diagnosed at advanced stages, which had a significant impact on survival. This highlights the necessity to access more effective therapies, further to actions focused to screening and monitoring current and future trends.

Key words:
Colorectal Neoplasms/drug therapy; Drug Therapy; Drug Use; Survival Analysis

Variable	Category	n (%)
Biological sex	Male	81 (51.3%)
Biological sex	Female	77 (48.7%)
Age range	Up to 49 years	20 (12.7%)
	50-59 years	59 (37.3%)
	60-69 years	55 (34.8%)
	70 years or more	24 (15.2%)
Race/color	White	36 (22.8%)
	Non White	93 (58.9%)
	Unknown	29 (18.3%)
Education	Illiterate	4 (2.5%)
	Elementary	57 (36.1%)
	High school	64 (40.5%)
	University	27 (17.1%)
	Unknown	6 (3.8%)
Comorbidities	Yes	97 (61.4%)
Comorbidities	No	61 (38.6%)
ICD-10	C18 – Malignant neoplasm of colon	76 (48.1%)
	C19 – Malignant neoplasm of rectosigmoid junction	12 (7.6%)
	C20 – Malignant neoplasm of rectum	70 (44.3%)
Histological differentiation	Well-differentiated	5 (3.2%)
	Moderately differentiated	134 (84.8%)
	Little differentiated	11 (7.0%)
	Unknown	8 (5.0%)
Mutations	KRAS	29 (18.3%)
	NRAS	2 (1.3%)
	KRAS + NRAS	1 (0.6%)
	Inconclusive	5 (3.2%)
	Non-mutated/wild	21 (13.3%)
	Unknown	100 (63.3%)
Staging	1	1 (0.6%)
	2	31 (19.6%)
	3	50 (31.7%)
	4	74 (46.8%)
	Unknown	2 (1.3%)
Metastases (stage IV patients)	1 Metastasis	44 (27.8%)
	2 Metastases	20 (12.7%)
	3 or more metastases	10 (6.3%)
Treatments utilized	Chemotherapy	20 (12.7%)
	Surgery + Chemotherapy	83 (52.5%)
	Radiotherapy + Chemotherapy	11 (7.0%)
	Surgery + Radiotherapy + Chemotherapy	44 (27.8%)
Start of chemotherapy treatment	Up to 1 month	9 (5.7%)
	1 to 3 months	48 (30.4%)
	3 to 6 months	61 (38.6%)
	6 months to 1 year	26 (16.5%)
	More than 1 year	14 (8.9%)
First-line treatment therapeutic regimens	Capecitabine	6 (3.8%)
	Capecitabine associated with radiotherapy	4 (2.5%)
	CAPOX	80 (50.6%)
	CAPOX associated with radiotherapy	13 (8.2%)
	FOLFIRI	2 (1.3%)
	FOLFOXIRI	5 (3.2%)
	FOLFOX	29 (18.3%)
	QUASAR	11 (7.0%)
	Other regimens	8 (5.0%)
Finality of first-line chemotherapy treatment	Neoadjuvant	25 (15.8%)
	Adjuvant	60 (38.0%)
	Palliative	72 (45.6%)
	Curative	1 (0.6%)
Dose reduction	No	114 (72.2%)
Dose reduction	Yes	44 (27.8%)
Status of the treatments	Completed	80 (50.6%)
	Interrupted	43 (27.2%)
	Modified	35 (22.2%)

Type of cancer	Finality of the treatment	Prescribed therapeutic regimens
Malignant neoplasm of the colon	Neoadjuvant	FOLFOX (2)
	Adjuvant	CAPOX (19), QUASAR (8), FOLFOX (7), capecitabine (5)
	Palliative	CAPOX (18), FOLFOX (11), FOLFIRI modified (2), FOLFIRI (1), FOLFOXIRI (1), FOLFOXIRI modified (1), irinotecan (1)
Malignant neoplasm of rectosigmoid junction	Neoadjuvant	CAPOX (1), FOLFOX (1)
	Adjuvant	CAPOX (3)
	Palliative	FOLFOX (3), CAPOX (2), MFLOX (1), FOLFOXIRI (1)
Malignant neoplasm of the rectum	Curative	CAPOX (1)
	Neoadjuvant	CAPOX + RT (10), CAPOX (5), capecitabine + RT (4), FOLFOX (1), FOLFOX + RT (1)
	Adjuvant	CAPOX (13), QUASAR (3), CAPOX + RT (1), FOLFOX (1)
	Palliative	CAPOX (18), FOLFOX (3), FOLFOXIRI (3), CAPOX + RT (2), Capecitabine oral (1), FOLFIRI (1), FOLFIRI mod. (1), NSABP modified + 5FU (1)

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Instituto Nacional de Câncer Rua Marquês de Pombal, 125 - 2º andar, Centro , CEP 20230-240, Tel.: +55 21 3207-6132 - Rio de Janeiro - RJ - Brazil
E-mail: rbc@inca.gov.br

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[1] Captions:

[TFN3] CAPOX: combination of oxaliplatin and capecitabine; FOLFOX: combination of oxaliplatin, fluorouracil and folinic acid; FOLFOXIRI: combination of oxaliplatin, fluorouracil and folinic acid with irinotecan; FOLFIRI: combination of irinotecan, fluorouracil and folinic acid; QUASAR: combination of fluorouracil and folinic acid.