Dose reductions, toxicities and survival in patients with excess weight undergoing adjuvant chemotherapy for colon and rectal cancers: individual patient data secondary analyses of consortium trials and causal inference modelling

  • Corinna Slawinski

Student thesis: Phd


Introduction: Elevated body mass index (BMI) may be associated with reduced survival in non-metastatic colorectal cancer (CRC). Whether this occurs directly, or indirectly through treatment-related mechanisms such as capping of adjuvant chemotherapy (ACT) doses and toxicity, is unclear. This thesis aimed to disentangle the effects of BMI, ACT adherence and toxicity on survival using individual participant data (IPD), causal mediation, and meta-analysis. Methods: Data from four randomised clinical ACT trials (MOSAIC, SCOT, CHRONICLE and PROCTOR-SCRIPT [five datasets - SCOT arms analysed individually]), with derivable BMI (at trial enrolment) cycle-level dosing and toxicity data were utilised from the OCTOPUS consortium. Dose capping was defined as
Date of Award31 Dec 2022
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorAndrew Renehan (Supervisor), Jorge Barriuso (Supervisor) & Hui Guo (Supervisor)


  • Mediation analysis
  • Causal Inference
  • Counterfactual
  • Meta-analysis
  • Individual Participant Data
  • Causal inference
  • Colorectal cancer
  • Survival
  • Toxicity
  • Adjuvant chemotherapy
  • Obesity

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