Impact of Adjuvant Chemotherapy in Patients With Colon Cancer

Overview

The present study aims to investigate the impact of adjuvant chemotherapy with 5-FU isolated and associated with oxaliplatin in cardiac autonomic control and endothelium-dependent vascular function in patients undergoing colectomy for stages II and III colon cancer. Will be performed evaluation of cardiac and vascular function, autonomic control, functional capacity and blood evaluations.

Full Title of Study: “Impact of Adjuvant Chemotherapy in Cardiovascular Autonomic Regulation in Patients With Colon Cancer”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: July 2017

Detailed Description

Cancer is a major public health problem. Colorectal cancer is the third most common cancer in men and women around the world. Despite advances in surgical and pharmacological treatment, this type of cancer remains a leading cause of cancer death in Western countries. The adjuvant chemotherapy treatment based on the use of fluoropyrimidine, especially 5-fluorouracil (5-FU) is the mainstay of the pharmacological treatment of colorectal cancer. This treatment showed benefit in overall survival and progression-free survival in the adjuvant treatment of patients with stage II and III disease. In the last decade, the combination treatment with oxaliplatin has shown benefit in patients with either metastatic disease as with locoregional disease who underwent surgical treatment. However, the increased use of 5-FU and oxaliplatin, and increased patient survival have caused increased incidence of adverse events. 5-FU has cardiotoxic effects that may range from 1.2 to 18% depending upon the drug administration. Another adverse event of chemotherapy for colon cancer is neurotoxicity. Peripheral neuropathy is one of the toxicities associated with treatment with Oxaliplatin and its characteristics to be dose-dependent and cumulative. Thus, the adjuvant chemotherapy with 5-FU and oxaliplatin may cause cardiotoxicity, changes in vascular function and increased oxidative stress. What is not known are the effects of treatment of 5-FU and oxaliplatin in cardiac autonomic modulation and peripheral vascular function. Therefore, the present study aims to investigate the impact of adjuvant chemotherapy with 5-FU isolated and associated with oxaliplatin in cardiac autonomic control and endothelium-dependent vascular function in patients undergoing colectomy for stages II and III colon cancer. Will be performed evaluation of cardiac and vascular function, autonomic control, functional capacity and blood evaluations.

Interventions

  • Drug: adjuvant chemotherapy with 5-FU isolated
    • Patients submitted to adjuvant chemotherapy with 5-FU isolated
  • Drug: adjuvant chemotherapy with 5-FU associated with oxaliplatin
    • Patients submitted to adjuvant chemotherapy with 5-FU associated with oxaliplatin

Arms, Groups and Cohorts

  • Active Comparator: Quimioterapy 1
    • adjuvant chemotherapy with 5-FU isolated
  • Active Comparator: Quimioterapy 2
    • adjuvant chemotherapy with 5-FU associated with oxaliplatin

Clinical Trial Outcome Measures

Primary Measures

  • cardiac function evaluation
    • Time Frame: Change from Baseline cardiac function at 6 months
    • Cardiac function will be assessed by two-dimensional (B-mode) echocardiography, pulsed Doppler

Secondary Measures

  • vascular function evaluation
    • Time Frame: Change from Baseline vascular function at 6 months
    • Vascular function will be assessed by high resolution Doppler ultrasound
  • autonomic control evaluation
    • Time Frame: Change from autonomic control at 6 months
    • autonomic control will be assessed by microneurography and heart rate variability
  • functional capacity evaluation
    • Time Frame: Change from Baseline functional capacity at 6 months
    • functional capacity will be assessed by cardiopulmonary exercise test
  • Proinflammatory cytokines
    • Time Frame: Change from Baseline Proinflammatory cytokines at 6 months
    • Proinflammatory cytokines will be assessed by blood evaluations

Participating in This Clinical Trial

Inclusion Criteria

  • Scale of Performance Status 0 – 1 – Patients submitted to colectomy for adenocarcinoma of colon stages II and III. Exclusion Criteria:

  • Severe pulmonary disease – Decompensated cardiovascular disease – Neurological disease – Insulin-dependent diabetes mellitus – Dialysis renal insufficiency

Gender Eligibility: All

Minimum Age: 30 Years

Maximum Age: 75 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Sao Paulo General Hospital
  • Collaborator
    • Fundação de Amparo à Pesquisa do Estado de São Paulo
  • Provider of Information About this Clinical Study
    • Sponsor

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