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Comparación de quimioterapia paliativa intermitente y continua para el cáncer colorrectal avanzado: un ensayo

T S Maughan¹, R D James, D J Kerr

¹Department of Oncology, Velindre Hospital, Cardiff, UK.

Lancet (London, England)

|February 14, 2003

Resumen

Para el cáncer colorrectal avanzado, detener la quimioterapia después de 12 semanas y reiniciar la progresión es seguro. Este enfoque de quimioterapia intermitente mostró menos efectos tóxicos que el tratamiento continuo, sin diferencias significativas en la supervivencia general.

Área de la Ciencia:

Oncología Oncología.
Los ensayos clínicos son ensayos clínicos.
Cánceres del tracto gastrointestinal Cánceres del tracto gastrointestinal

Sus antecedentes:

La duración de la quimioterapia para el cáncer colorrectal avanzado varía entre los médicos del Reino Unido.
La falta de políticas coherentes requiere estudios comparativos de eficacia.

Objetivo del estudio:

Para comparar la efectividad de la quimioterapia continua versus la intermitente en el cáncer colorrectal avanzado.
Para evaluar los resultados de seguridad y supervivencia entre las dos estrategias de quimioterapia.

Principales métodos:

Los pacientes con cáncer colorrectal avanzado, que respondieron o se mantuvieron estables después de 12 semanas de regímenes específicos de quimioterapia, fueron asignados al azar.
Grupo intermitente: pausa en la quimioterapia, reinicio en la progresión. Grupo continuo: quimioterapia hasta la progresión.

Principales resultados:

Se inscribieron 354 pacientes. La quimioterapia intermitente resultó en significativamente menos efectos tóxicos y eventos adversos graves.
No se observó una diferencia clara en la supervivencia general entre los grupos de quimioterapia intermitente y continua.
Solo el 37% de los pacientes en terapia intermitente se reinició como estaba planeado.

Conclusiones:

Continuar la quimioterapia indefinidamente hasta que la progresión de la enfermedad no ofrezca un beneficio claro de supervivencia.
Detener la quimioterapia después de 12 semanas y reiniciar la progresión es una estrategia segura para el cáncer colorrectal avanzado quimio-sensible.
La quimioterapia intermitente demuestra un perfil de seguridad favorable.

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