Conversion Chemotherapy With a Modified FLOX Regimen for Borderline or Unresectable Liver Metastases From Colorectal Cancer: An Alternative for Limited-Resources Settings

被引:7
作者
Bonadio, Renata Colombo [1 ,2 ]
Amor Divino, Paulo Henrique [1 ,2 ]
Madero Obando, Jorge Santiago [1 ]
Alvino Lima, Karolina Cayres [1 ]
Recchimuzzi, Debora Zachello [1 ]
Pirola Kruger, Jaime Arthur [1 ]
Saragiotto, Daniel Fernandes [1 ,2 ]
Capareli, Fernanda C. [3 ]
Hoff, Paulo M. [1 ,2 ]
机构
[1] Inst Canc Estado Sao Paulo, Av Dr Arnaldo 251, BR-01246000 Sao Paulo, SP, Brazil
[2] Oncol Dor, Sao Paulo, Brazil
[3] Hosp Sirio Libanes, Sao Paulo, Brazil
来源
JOURNAL OF GLOBAL ONCOLOGY | 2019年 / 5卷
关键词
PHASE-II TRIAL; 1ST-LINE TREATMENT; OXALIPLATIN; LEUCOVORIN; FLUOROURACIL; IRINOTECAN; CETUXIMAB; BEVACIZUMAB; FOLFOXIRI; FOLFIRI;
D O I
10.1200/JGO.19.00180
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PURPOSE Conversion chemotherapy is often used for borderline or unresectable (B/U) liver metastases from colorectal cancer (CRC) with the aim of achieving resectability. Although intensive and costly regimens are often used, the best regimen in this scenario remains unclear. We aimed to evaluate the outcomes of patients with B/U liver metastases from CRC treated with conversion chemotherapy with the modified fluorouracil, leucovorin, and oxaliplatin (mFLOX) regimen followed by metastasectomy. METHODS We performed a single-center retrospective analysis of patients with B/U liver metastases from CRC treated with chemotherapy with the mFLOX regimen followed by surgery. B/U disease was defined as at least one of the following: more than four lesions, involvement of hepatic artery or portal vein, or involvement of biliary structure. RESULTS Fifty-four consecutive patients who met our criteria for B/U liver metastases were evaluated. Thirty-five patients (64%) had more than four liver lesions, 16 (29%) had key vascular structure involvement, and 16 (29%) had biliary involvement. After chemotherapy, all patients had surgery and 42 (77%) had R0 resection. After a median follow-up of 37.2 months, median progression-free survival (PFS) was 16.9 months and median overall survival (OS) was 68.3 months. R1-R2 resections were associated with worse PFS and OS compared with R0 resection (PFS: hazard ratio, 2.65; P = .007; OS: hazard ratio, 2.90; P = .014). CONCLUSION Treatment of B/U liver metastases from CRC with conversion chemotherapy using mFLOX regimen followed by surgical resection was associated with a high R0 resection rate and favorable survival outcomes. On the basis of our results, we consider mFLOX a low-cost option for conversion chemotherapy among other options that have been proposed. (C) 2019 by American Society of Clinical Oncology
引用
收藏
页码:1 / 6
页数:6
相关论文
共 31 条
  • [31] Randomized Controlled Trial of Cetuximab Plus Chemotherapy for Patients With KRAS Wild-Type Unresectable Colorectal Liver-Limited Metastases
    Ye, Le-Chi
    Liu, Tian-Shu
    Ren, Li
    Wei, Ye
    Zhu, De-Xiang
    Zai, Sheng-Yong
    Ye, Qing-Hai
    Yu, Yiyi
    Xu, Bo
    Qin, Xin-Yu
    Xu, Jianmin
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2013, 31 (16) : 1931 - 1938