COMPARATIVE METABOLIC TOXICITY IN PATIENTS OF ADVANCED COLORECTAL CARCINOMA TREATED WITH DIFFERENT SCHEDULES OF FOLFOX
Rahila Najam, Nusrat Bano and Ahmed Mateen
Department of Pharmacology, University of Karachi
Objective & Background: The objective of the study was to comparatively assess the clinical parameters of metabolic toxicity in patients of advanced colorectal carcinoma with and without known hepatic and metabolic disorders treated with four different schedules of FOLFOX.
Patients and Methods: Patients admitted for treatment at KIRAN in 2009-2012 were assessed for symptoms like Anorexia, weight loss, dehydration and cachexia following each cycle of treatment and evaluated according to CTC v.2.0 toxicity criteria. The symptoms were correlated with chemotherapy induced changes in hepatic biomarkers and hyperglycemia and comparatively evaluated in each treatment arm.
Results: The difference in the Incidence rate and severity of Weight loss (p=0.05) and dehydration (p=0.05) was significant between patients with and without previous hepatic disorders. The difference in treatment induced elevation of Alkaline phosphate, Bilirubin, ALT & AST levels between patients of previous cardiac disease and normal general status prior to chemotherapy was highly significant. Despite remarkable cachexia in most patients glucose levels were adversely elevated in hepatic and diabetic patients in FOLFOX 7(p=0.001) and mFOLFOX6 (p=0.013).
Conclusion: The patients with already known hepatic disorders are at an increased risk level to Oxaliplatin induced metabolic and hepatic toxicity whereas the risk of similar toxicity is comparatively less in Diabetic patients.
Keywords: Cachexia, FOLFOX, Anorexia, Hepatic.