Effectiveness of Liver Metastasectomies in Patients With Metastatic Colorectal Cancer Treated With FIr-B/FOx Triplet Chemotherapy Plus Bevacizumab

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• 作者：Gemma Bruera¹ ; Katia Cannita¹ ; Felice Giuliante² ; Paola Lanfiuti Baldi¹ ; Roberto Vicentini³ ; Paolo Marchetti⁴ ; Gennaro Nuzzo² ; Adelmo Antonucci³ ; Corrado Ficorella¹ ; Enrico Ricevuto¹ ; ^{enrico.ricevuto@univaq.it}
• 关键词：Integrated treatments ; Intensive chemotherapy ; Liver limited ; Liver only ; Liver surgery
• 刊名：Clinical Colorectal Cancer
• 出版年：2012
• 期刊代码：pca91_15330028
• 类别：med
• 出版时间：June, 2012
• 卷：11
• 期：2
• 页码：119-126
• 文件大小：362 K

摘要

Background

Intensive medical treatment increases resection rate of liver metastases in patients with metastatic colorectal cancer (MCRC). The effectiveness of liver metastasectomies was evaluated in patients with MCRC who were treated with previously reported FIr-B/FOx (triplet chemotherapy plus bevacizumab).

Patients and Methods

Fifty patients with MCRC enrolled in the reported phase II study were classified according to involved metastatic sites (liver-only metastatic site, multiple metastatic sites) and the extent of liver metastases (single, multiple). Surgical resectability of liver metastases was evaluated at baseline and every 3 cycles of FIr-B/FOx treatment. The resection rate of liver metastases, activity, and efficacy were evaluated; progression-free survival (PFS) and overall survival (OS) were compared by using the log-rank test.

Results

Patients with liver MCRC were 33 of 50 consecutive unselected patients with MCRC: liver limited, 22 patients; multiple metastatic sites, 11 patients. Liver metastasectomies were performed in 13 patients: 26%of 50 patients with MCRC, 39%of 33 patients with liver MCRC. In patients with liver-only MCRC, a secondary liver surgery was performed in 54%: 6 of 9 single and 6 of 13 multiple liver metastases. Also, 1 liver and lung metastasectomy was performed. Pathologic complete responses were achieved in 2 patients (15%). The conversion rate of unresectable liver metastases was 83%. Objective response rate, PFS, OS were, respectively: 84%, 11 and 23 months in 33 liver MCRC; 86%, 17 and 44 months in 22 liver-limited patients. PFS and OS were significantly increased in patients with liver-limited metastases compared with multiple metastatic sites and single compared with multiple liver metastases.

Conclusion

The FIr-B/FOx regimen may increase the resection rate of liver metastases and improve clinical outcome of patients with liver-only MCRC.