Comparison of Efficacy and Safety between CAPOX and FOLFOX6 in Metastatic Colorectal Carcinoma
DOI:
https://doi.org/10.66984/jsmdc.v12.i01.oa.09Keywords:
Colorectal Neoplasms, Neoplasm metastasis, Capecitabine, OxaliplatinAbstract
Objective: To compare the efficacy and safety of CAPOX versus FOLFOX6 in patients with metastatic colorectal carcinoma in terms of disease progression, mortality, and treatment-related toxicities.
Methodology: This randomized controlled trial was conducted at the Department of Oncology, Jinnah Hospital, Lahore, from September 2025 to February 2026, following ethical approval from the institutional review board. Patients aged 20 to 80 years with metastatic colorectal carcinoma planned for postoperative chemotherapy were recruited using a non-probability consecutive sampling technique after obtaining informed written consent. A total of 248 patients were screened, of whom 216 eligible patients were randomized to either CAPOX or FOLFOX6 treatment groups. During follow-up, 15 patients in the CAPOX group and 22 patients in the FOLFOX6 group were lost to follow-up; therefore, the final analysis was performed on 179 patients, including 93 in the CAPOX group and 86 in the FOLFOX6 group. Outcomes included disease progression, dose reduction, hepatotoxicity, diarrhea, neuropathy, treatment discontinuation, and mortality. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 26.
Results: Baseline demographic and clinical characteristics were comparable between the two groups (p >0.05). Disease progression occurred in 25(26.9%) patients in the CAPOX group and 32(37.2%) patients in the FOLFOX6 group [odd ratio (OR) 0.62, 95% confidence interval (CI):0.33-1.17; p=0.138]. Neuropathy was significantly less frequent in the CAPOX group compared with the FOLFOX6 group (24.7% vs. 47.7%; p=0.001). Hepatotoxicity was less frequent in the CAPOX group than in the FOLFOX6 group (5.4% vs. 14.0%); however, this difference did not reach statistical significance (p=0.051). Mortality, dose reduction, treatment discontinuation, and diarrhea did not differ significantly between the groups (p >0.05).
Conclusion: In patients with metastatic colorectal carcinoma, CAPOX was associated with a significantly lower frequency of neuropathy compared with FOLFOX6. CAPOX and FOLFOX6 treatment groups showed no statistically significant difference in disease progression, mortality, dose reduction, hepatotoxicity, diarrhea, and treatment discontinuation.
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