Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, 5 Fu-Hsing Street, Kwei-Shan, Tao-Yuan 333, Taiwan, ROC.
Anticancer Res. 2013 Aug;33(8):3317-25.
Postoperative 5-fluorouracil (5-FU)-based chemotherapy improves survival after resection of synchronous liver metastases from colorectal cancer (CRLM). We retrospectively assessed the efficacy of postoperative chemotherapy with a modern regimen containing of oxaliplatin or irinotecan after curative resection of synchronous CRLM.
Seventy-two patients who received postoperative chemotherapy following curative resection of synchronous CRLM were analyzed. Patients were categorized into fluorouracil plus leucovorin (5-FU/LV, n=25), irinotecan-based regimen (FOLFIRI/IFL, n=21) and oxaliplatin-based regimen (FOLFOX, n=26) groups, according to the postoperative chemotherapy regimen. The clinicopathological parameters of patients were analyzed to evaluate clinical outcome.
Median relapse-free survival (RFS) was 14.4 months in the 5-FU/LV group vs. 20.8 months in the FOLFIRI/IFL group (p=0.032) and 18.8 months in the FOLFOX regimen (p=0.123). Median overall survival (OS) was >60 months in the FOLFOX and FOLFIRI/IFL groups vs. 38.5 months in the 5-FU/LV group (p=0.002 and p=0.019, respectively). In multivariate analysis, administrations of FOLFIRI/IFL or FOLFOX regimens were independent predictive factors for favorable RFS. Administration of the FOLFIRI/IFL regimen was the only independent predictive factor for favorable OS.
Postoperative FOLFIRI/IFL and FOLFOX chemotherapy lead to more favorable RFS than 5-FU/LV following curative resection of synchronous CRLM.
结直肠癌(CRC)肝转移患者接受同步切除术后,应用含氟尿嘧啶(5-FU)的化疗方案可提高生存率。我们回顾性评估了奥沙利铂或伊立替康为基础的现代方案在同步 CRC 肝转移根治性切除术后辅助化疗中的疗效。
分析 72 例同步 CRC 肝转移根治性切除术后接受辅助化疗的患者。根据术后化疗方案,将患者分为氟尿嘧啶+亚叶酸(5-FU/LV,n=25)、伊立替康方案(FOLFIRI/IFL,n=21)和奥沙利铂方案(FOLFOX,n=26)组。分析患者的临床病理参数,以评估临床结局。
5-FU/LV 组的中位无复发生存期(RFS)为 14.4 个月,FOLFIRI/IFL 组为 20.8 个月(p=0.032),FOLFOX 组为 18.8 个月(p=0.123)。FOLFOX 和 FOLFIRI/IFL 组的中位总生存期(OS)均>60 个月,5-FU/LV 组为 38.5 个月(p=0.002 和 p=0.019)。多因素分析显示,FOLFIRI/IFL 或 FOLFOX 方案的应用是 RFS 良好的独立预测因素。FOLFIRI/IFL 方案的应用是 OS 良好的唯一独立预测因素。
与 5-FU/LV 方案相比,同步 CRC 肝转移根治性切除术后应用 FOLFIRI/IFL 和 FOLFOX 化疗可获得更好的 RFS。