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P OSTER
A BSTRACTS
B130
Early Discontinuation of Adjuvant Chemotherapy among Veterans
with Colon Cancer.
H. Riggs, 1,4 K. Lane, 1 S. Rawl, 3,4 P. Loehrer, 1,4 S. Hui, 1 M. Weiner. 1,2 1.
Indiana University School of Medicine, Indpls, IN; 2. Center of
Excellence on Implementing Evidence-Based Practice, VHA HSR&D
HFP 04-148 at Richard L. Roudebush VA Medical Center, Indpls, IN;
3. Indiana University School of Nursing, Indpls, IN; 4. Indiana
University Melvin and Bren Simon Cancer Center, Indpls, IN.
Supported By: John A. Hartford Foundation
BACKGROUND: Standard therapy for patients (pts) with
colon cancer and high-risk features or lymph node involvement is 6
months (mos) of adjuvant chemotherapy (C) after surgical resection.
Receipt of 5 mos or less of C may be a marker for inferior outcomes.
Whether advanced age, regimen-specific or other clinical and demographic
factors are associated with delivery of C is uncertain. We evaluated
the association of baseline characteristics and planned C regimen
with C delivery in pts with resected colon cancer.
METHODS: We identified stage II or III colon cancer pts from
our local VA tumor registry and assembled a cohort who initiated C
at our VA between 2004 and 2010. C delivery was measured as the
percentage of planned cumulative dose (PCD) of C that was actually
delivered. Baseline characteristics were pts’ demographics, disease
stage, travel distance to the treatment site, Adult Comorbidity Evaluation-27
score (ACE), and lab results. We classified C as oral
capecitabine- or intravenous 5-fluorouracil-based and as oxaliplatinor
non-oxaliplatin-containing. Linear regression tested each association
with PCD. Toxicities, hospitalization, and other reasons for modifying
or discontinuing C were recorded.
RESULTS: Fifty pts (98% male) initiated C for stage II (n=6)
and III (n=44) disease. Median age was 63 years (range 41-82); median
baseline estimated glomerular filtration rate (GFR) was 83
mL/min/1.76 m 2 (range 26-171); 76% were white; 28% were married;
52% had moderate or severe comorbidity; 74% received oxaliplatin;
and 24% received oral capecitabine. The median travel distance was
40 miles. The median PCD was 75%; median treatment duration was
5 mos. Lower PCD was associated with older age (P=0.05), lower
GFR (P=0.05), higher travel distance (P=0.02), and receipt of
capecitabine (P