Division of Medical Oncology, Rochester, MN, USA.
Ther Clin Risk Manag. 2008 Dec;4(6):1363-6. doi: 10.2147/tcrm.s3951.
Do colorectal cancer patients with hyperbilirubinemia and liver metastases benefit from chemotherapy?
METHODS/RESULTS: This study entailed a review of 3,019 consecutive patients with colorectal cancer. Within this cohort, 20 met the study's a priori selection criteria, which included a new diagnosis of colorectal cancer, no prior therapy, and a total bilirubin of ≥3.0 mg/dL. All 20 patients had liver metastases, and as a whole the group had a median serum bilirubin of 6.4 mg/dL (range 3.1, 28 mg/dL). Six patients received chemotherapy with an oxaliplatin-containing regimen, and four subsequently sustained a drop in their bilirubin. In one instance, a drop from 27.2 to 2.5 mg/dL occurred. These six patients lived a median of 71 days (range 23+, 283 days), but one treatment-related death occurred. In contrast, patients who received only supportive care lived a median of 28 days.
Chemotherapy appears to provide modest benefit to newly diagnosed colorectal cancer patients with severe hyperbilirubinemia.
结直肠癌伴高胆红素血症和肝转移患者是否从化疗中获益？
方法/结果：本研究纳入了 3019 例连续的结直肠癌患者。在该队列中，有 20 例符合研究的事先选择标准，包括结直肠癌的新诊断、无先前治疗和总胆红素≥3.0mg/dL。所有 20 例患者均有肝转移，总体中位血清胆红素为 6.4mg/dL（范围 3.1，28mg/dL）。6 例患者接受了含奥沙利铂的化疗方案治疗，其中 4 例随后胆红素下降。在一例中，胆红素从 27.2 降至 2.5mg/dL。这 6 例患者的中位生存期为 71 天（范围 23+，283 天），但有 1 例与治疗相关的死亡。相比之下，仅接受支持治疗的患者中位生存期为 28 天。
化疗似乎为新诊断的伴有严重高胆红素血症的结直肠癌患者带来了一定的获益。
