Impact of Adjuvant FOLFOX on Quality of Life and Peripheral Neuropathy Incidence in Patients With Gastric Cancer: A Prospective Cohort Study

Value Health Reg Issues. 2023 May:35:13-18. doi: 10.1016/j.vhri.2022.12.005. Epub 2023 Feb 17.

Abstract

Objectives: Perioperative and adjuvant chemotherapy have demonstrated clinical benefits in localized gastric cancer. Nevertheless, the reports on their effects on patient's health-related quality of life (HRQoL) are scarce. Here, we prospectively assessed quality of life and the incidence of chemotherapy-induced peripheral neuropathy (CIPN) in a cohort of patients treated with adjuvant FOLFOX.

Methods: Localized stomach or gastroesophageal junction adenocarcinoma patients who underwent curative resection were recruited at a single center. All patients received adjuvant FOLFOX6, and HRQoL and CIPN were assessed using the European organization for research and treatment of cancer quality life (EORTC) C30 and the EORTC CIPN20 questionnaires, respectively. Clinically significant deterioration of HRQoL was also assessed as a coprimary outcome in a longitudinal analysis.

Results: We recruited a total of 63 patients. Median age was 62.5 years, and 75% had stomach tumors. Twenty-four weeks after the start of treatment, the probability of being free from HRQoL deterioration and CIPN was 29% (95% confidence interval [CI] 18%-42%) and 6% (95% CI 2%-17%), respectively. Five-year disease-free survival was 45% (95% CI 24%-64%) and 5-year overall survival was 63% (95% CI 48%-76%).

Conclusions: Adjuvant FOLFOX is associated with a high rate of long-term survival in localized gastric cancer; nevertheless, it has detrimental effects on patients' quality of life.

Keywords: adjuvant chemotherapy; chemotherapy-induced peripheral neuropathy; gastric cancer.

MeSH terms

  • Humans
  • Incidence
  • Middle Aged
  • Peripheral Nervous System Diseases* / chemically induced
  • Peripheral Nervous System Diseases* / epidemiology
  • Peripheral Nervous System Diseases* / pathology
  • Prospective Studies
  • Quality of Life
  • Stomach Neoplasms* / drug therapy
  • Stomach Neoplasms* / epidemiology