Introduction: Adjuvant chemotherapy is considered the standard of care for patients with colorectal cancer after curative resection. Studies on adjuvant and metastatic colorectal cancer showed FOLFOX4 and CAPEOX are equal in efficacy (Progression free survival (PFS), OS) but differ in terms of Toxicity and Compliance. Aims: The present study is aimed to compare the toxicity and compliance between FOLFOX4 and CAPEOX in adjuvant and metastatic colorectal cancer. Materials and Methods: Prospective randomized comparative study of patients with adjuvant and metastatic colorectal cancer who are histopathologically confirmed colorectal malignancy with high risk Stage II, Stage III, Stage IV Colorectal cancer. Results: The baseline characteristics between the two groups were comparable in almost all aspects. Incidence of grade 3 (41.4% v 7%) and grade 4 (20.7% v 0%) neutropenia were higher with FOLFOX4 arm as compared to the CAPOX arm which showed a statistical significance (p=0.000). As compared to the FOLFOX4 arm, CAPOX arm showed a higher incidence of grade 2 (51.2% v 0%) and grade 3 (27.9% v 0%) hand foot syndrome (HFS) which is statistically significant (p=0.000). Dose limiting toxicities (DLTs) were seen with 95.3% patients in the CAPOX arm and 96.6% patients in the FOLFOX4 arm. Patients in the CAPOX arm showed a higher compliance rates (CAPOX 60.5%, FOLFOX4 31%) than patients in the FOLFOX4 arm with a statistical significance (p=0.014). Conclusion: The overall grade 3 and 4 toxicity is significant with FOLFOX4 arm as compared to CAPOX arm. CAPOX arm isassociated with a higher incidence of grade 2 & 3 hand foot syndrome (HFS), Patients who received CAPOX showed a better compliance to treatment as compared to patients who received FOLFOX4.

Keywords: Infusional 5-Floro Uracil (FOLFOX4); Capecitabine (CAPOX); Colorectal cancer (CRC).