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Adjuvant chemotherapy 

Adjuvant chemotherapy
Chapter:
Adjuvant chemotherapy
Author(s):

Uschi Hofmann

, Fiona Collinson

, Peter Hall

, Mike Braun

, and Daniel Swinson

DOI:
10.1093/med/9780199590209.003.0006
Page of

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date: 01 December 2020

Adjuvant single agent fluoropyrimidine (Fu) reduces the relative risk of death following potentially curative surgery by 20–30%. Addition of oxaliplatin reduces relative risk by a further 15%

The risk reduction is proportional to the absolute risk so the higher the risk the greater the benefit. Thus adjuvant chemotherapy only achieves a meaningful benefit for patients with stage III and high risk stage II disease

The benefit from single agent Fu does not diminish with age although data is limited for patients over the age of 80. In contrast the benefit of the addition of oxaliplatin is questionable over the age of 70

Discussions with patients should include an estimate of the chances of benefit with single agent and combination adjuvant chemotherapy.

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