Department of Internal Medicine, Division of Medical Oncology, Faculty of Medicine, Ege University, Bornova/Izmir, Turkey.
Am J Clin Oncol. 2013 Aug;36(4):388-91. doi: 10.1097/COC.0b013e318248da7c.
The liver is the most common metastatic site in colorectal cancer (CRC). In this study, we evaluated if there is any difference between first-line irinotecan-based and oxaliplatin-based chemotherapies in the duration of time to disease progression (TTP) in CRC patients with only liver metastasis.
We retrospectively reviewed the medical records of patients with metastatic CRC referred to the Medical Oncology Department at the Faculty of Medicine of Ege University, between January 2002 and December 2010. Seventy-seven patients had only liver metastasis and completed their first-line chemotherapy. Forty-two patients had oxaliplatin-based treatments while 12 also had bevacizumab therapy, and 35 patients had irinotecan-based treatments while 16 also had bevacizumab therapy.
Median TTP was 6.70 ± 0.29 months for patients treated with oxaliplatin+5-fluorouracil (5-FU) and 8.33 ± 1.15 months for patients treated with oxaliplatin+5-FU+bevacizumab. TTP was significantly improved for patients who received irinotecan+5-FU+bevacizumab (median TTP, 13.73 ± 2.10 mo) when compared with irinotecan+5-FU (median TTP, 5.13 ± 0.70 mo).
Although previous studies showed no survival difference between these 2 chemotherapeutic agents in metastatic CRC, there might be differences in the benefit of delaying the disease progression in subgroup populations. Irinotecan+5-FU with bevacizumab combination chemotherapy may be superior in the first-line treatment of CRC with hepatic only metastasis.
肝脏是结直肠癌(CRC)最常见的转移部位。在这项研究中,我们评估了对于仅有肝转移的 CRC 患者,一线伊立替康为基础和奥沙利铂为基础的化疗在疾病进展时间(TTP)方面是否存在差异。
我们回顾性地审查了 2002 年 1 月至 2010 年 12 月期间在伊兹密尔艾菲斯大学医学院肿瘤内科就诊的转移性 CRC 患者的病历。77 例患者仅有肝转移且完成了一线化疗。42 例患者接受奥沙利铂为基础的治疗,其中 12 例还接受贝伐单抗治疗,35 例患者接受伊立替康为基础的治疗,其中 16 例还接受贝伐单抗治疗。
接受奥沙利铂+5-氟尿嘧啶(5-FU)治疗的患者中位 TTP 为 6.70 ± 0.29 个月,接受奥沙利铂+5-FU+贝伐单抗治疗的患者中位 TTP 为 8.33 ± 1.15 个月。与接受伊立替康+5-FU 治疗的患者相比,接受伊立替康+5-FU+贝伐单抗治疗的患者 TTP 显著改善(中位 TTP:13.73 ± 2.10 mo)。
尽管先前的研究表明在转移性 CRC 中这两种化疗药物的生存结果没有差异,但在亚组人群中延迟疾病进展的获益可能存在差异。伊立替康+5-FU 联合贝伐单抗化疗可能在仅有肝转移的 CRC 的一线治疗中更具优势。