Chemotherapy prescription patterns in colon cancer: a patterns-of-care survey in New Zealand.

New Zealand Medical Journal 120(1258):U2636 (2007) PMID 17653254

Colorectal cancer is the second most common site of cancer for both men and women in New Zealand (NZ). Survival, especially with metastatic disease, has improved considerably over the last decade with the introduction of new chemotherapeutic agents. A questionnaire-based survey was conducted to document variations in chemotherapy prescription patterns throughout NZ. Out of 25 medical oncologists, responses were obtained from 22 (88%). The patient with stage III colon cancer was offered either 5-fluorouracil/leucovorin, most commonly on the weekly bolus schedule, or capecitabine monotherapy. Chemotherapy was also offered by the majority (65%) of respondents to the patient with 'high-risk' stage II colon cancer. Several chemotherapy combinations are available in NZ in the metastatic setting, with the most popular being oxaliplatin/capecitabine combination (CAPOX) (35%) or irinotecan/5-FU combination (FOLFIRI) (23%). None of the respondents would commence chemotherapy solely on the basis of a rising carcinoembryonic antigen (CEA). Two-thirds of respondents would recommend chemotherapy for the patient with resectable liver metastases, either before or after surgery. Our survey indicates that chemotherapy prescriptions for patients with colon cancer in NZ, though not uniform, are mostly in line with international recommendations.