Comparison of Complete Pathologic Response and Hepatic Injuries Between Hepatic Arterial Infusion and Systemic Administration of Oxaliplatin in Patients with Colorectal Liver Metastases

被引:24
作者
Allard, Marc Antoine [1 ,8 ]
Sebagh, Mylene [2 ,9 ]
Baillie, Gaelle [4 ]
Lemoine, Antoinette [3 ,8 ]
Dartigues, Peggy [6 ]
Faitot, Francois [4 ]
Faron, Matthieu [4 ]
Boige, Valerie [5 ]
Vitadello, Fabrizio [4 ]
Vibert, Eric [1 ,9 ]
Elias, Dominique [4 ]
Adam, Rene [1 ,7 ]
Goere, Diane [4 ]
Cunha, Antonio Sa [1 ,7 ]
机构
[1] Hop Paul Brousse, Ctr Hepatobiliaire, Villejuif, France
[2] Hop Paul Brousse, Dept Pathol, Villejuif, France
[3] Hop Paul Brousse, Dept Mol Biol, Villejuif, France
[4] Gustave Roussy, Dept Surg Oncol, Villejuif, France
[5] Gustave Roussy, Dept Med Oncol, Villejuif, France
[6] Gustave Roussy, Dept Pathol, Villejuif, France
[7] Hop Paul Brousse, INSERM, U776, Villejuif, France
[8] Hop Paul Brousse, INSERM, U1004, Villejuif, France
[9] Hop Paul Brousse, INSERM, U785, Villejuif, France
关键词
SINUSOIDAL OBSTRUCTION SYNDROME; PREOPERATIVE CHEMOTHERAPY; MAJOR HEPATECTOMY; TUMOR-RESPONSE; CANCER; RESECTION; SURGERY; HYPERPLASIA; CATHETER; FOLFIRI;
D O I
10.1245/s10434-014-4272-7
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Whether hepatic arterial infusion (HAI) of oxaliplatin influences the rates of complete pathologic response (CPR) and severe oxaliplatin-related lesions (SOxL) in patients with colorectal liver metastases (CRLM) is unknown. This study aimed to compare the incidence of CPR and SOxL between systemic (intravenous, IV) and HAI administration. All patients with initially unresectable CRLM who had undergone hepatic resection in two expert centers between 2004 and 2010 after at least 6 cycles of oxaliplatin-based chemotherapy administered either via HAI (n = 18) or IV (n = 50) were included. The presence of CPR and SOxL were evaluated by two pathologists. A 1:2 case match using a propensity score was used. A CPR was observed significantly more often after HAI (33 vs. 10 %, P = 0.03). However, SOxL had occurred more frequently in patients in the HAI group versus the IV group, 66 and 20 %, respectively (P < 0.001). On a well-balanced cohort, HAI was associated with higher chance of CPR (odds ratio 9.33, 95 % confidence interval 1.59-54.7) but also higher risk of SOxL (odds ratio 13.7, 95 % confidence interval 3.08-61.3). A CPR markedly enhanced overall survival (OS) and disease-free survival (median OS of 114 vs. 42 months, P = 0.02; median disease-free survival of 51 vs. 12 months, P = 0.002). Patients with SOxL did not experience different outcome (median OS of 42 vs. 50 months, respectively; P = 0.92) HAI of oxaliplatin increases the likelihood of a CPR at the cost of a higher incidence of SOxL in patients with initially unresectable CRLM.
引用
收藏
页码:1925 / 1932
页数:8
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