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INTRODUCTION: Combinations of 5-fluorouracil/leucovorin (5-FU/LV) with oxaliplatin (FOLFOX) or irinotecan (FOLFIRI) are part of standard treatments for metastatic colorectal cancer (mCRC). For these molecules, the impact of a low relative dose intensity (RDI) on survival is not sufficiently known in real-life. MATERIAL AND METHODS: Data were collected retrospectively from patients treated in our center for an unresectable mCRC with FOLFOX or FOLFIRI as a first-line treatment. To study the impact on progression-free survival (PFS) and overall survival (OS), patients were divided into high and low RDI according to the median RDI of 5-FU on one end, and the median RDI of oxaliplatin or irinotecan (OXA-IRI) on the other. RESULTS: In our population of 75 patients, the median age was 67.1 years and 77% of patients were treated with FOLFIRI. Patients with high RDI for OXA-IRI had better PFS compared to patients with low RDI (hazard ratio [HR], 0.58; p = 0.03). There was no statistically significant difference in PFS for patients with high RDI for 5-FU (HR, 0.66; p = 0.09). No difference was found in overall survival according to the RDI of OXA-IRI (HR, 0.72; p = 0.18) or 5-FU (HR, 0.77; p = 0.29). RDI had no significant impact on toxicities. CONCLUSIONS: Our analysis suggests that a low RDI of oxaliplatin and irinotecan has a negative effect on PFS. RDI had no significant effect on OS in our cohort. The clinical benefit of maintaining high RDI in these patients appears low.
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PURPOSE: The objective of our study was to assess the rate of work adjustments 1 year after the diagnosis in a population of female breast cancer (BC) survivors, in the context of the French system of social protection. We also characterised these adjustments and their influence on the reduction of professional exclusion of patients 1 year after the diagnosis. METHODS: This observational, prospective study was conducted from February 2015 to April 2016 among female patients with BC. Inclusion criteria were women aged between 18 and 65 years, treated for BC and integrated into the labour market at the time of diagnosis (working or on sick leave). Exclusion criteria were metastatic BC, retired patients and refusal to participate. A 1-year follow-up was scheduled, and data collection was performed with questionnaires. RESULTS: In total, 213 patients were included between February 2015 and April 2016. One year after the diagnosis (T1), among 185 BC survivors, 78 (42.2%) patients were working. Among them, 13 patients did not interrupt their occupational activity and 65 returned to work after a period of sick leave. Sixty-four patients returned to work after the end of chemotherapy (after 6 months), and one returned to work before this therapeutic threshold. Sixty-six patients (35.7%) benefited from at least one adjustment of their work conditions to facilitate their return to work (RTW) or maintenance at work: working hours were decreased for 43 patients, and workstation changes were performed for 22 patients. An occupational health physician was involved for some patients; work adjustments were prescribed to 42 patients, 7 patients had medical restrictions for physical reasons and 4 patients had restrictions for psychological reasons. Forty-three patients benefited from part-time work prescribed for therapeutic reasons. CONCLUSIONS: Referral to occupational health physicians and work adjustments remain limited in the process of RTW or maintenance at work after BC in France, despite their positive impact.
