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经皮导管置入技术用于结直肠癌肝转移肝动脉灌注化疗的II期研究(JFMC28研究)。

Phase II study on hepatic arterial infusion chemotherapy using percutaneous catheter placement techniques for liver metastases from colorectal cancer (JFMC28 study).

作者信息

Arai Yasuaki, Aoyama Toru, Inaba Yoshitaka, Okabe Haruumi, Ihaya Takashi, Kichikawa Kimihiko, Ohashi Yasuo, Sakamoto Junichi, Oba Koji, Saji Shigetoyo

机构信息

National Cancer Center, Central Hospital, Tokyo, Japan.

出版信息

Asia Pac J Clin Oncol. 2015 Mar;11(1):41-8. doi: 10.1111/ajco.12324. Epub 2015 Jan 12.

Abstract

AIM

This prospective multicenter study aimed to evaluate the efficacy and adverse events of hepatic arterial infusion chemotherapy (HAIC) using percutaneous catheter placement techniques for liver metastases from colorectal cancer (CRC).

METHODS

We administered 5-fluorouracil at 1000 mg/m2 over 5 h via hepatic arterial infusion on a weekly schedule. The primary endpoint was the overall response rate (RR). The secondary endpoints were the overall survival (OS), progression-free survival (PFS) and toxicities.

RESULTS

Between February 2000 and March 2002, seventy-seven eligible patients were enrolled in this study. After a median of 26 treatment cycles, 4 patients achieved a complete response, 29 achieved a partial response, 28 had stable disease, 15 had progressive disease and the status of one patient was unknown. The overall RR was 42.9% and the disease control rate (DCR) was 79.2%. The median PFS and OS times were 203 and 560 days, respectively. The most common grade 3 or 4 hematological and non-hematological toxicities were total bilirubin level elevation (10.4%) and gamma-glutamyl transferase level elevation (10.4%). With regard to the relationship between the background factors and treatment outcomes, the DCR, RR, PFS and OS were different between patients with and without extrahepatic lesions (DCR: 86.5% vs 64%, RR: 46.2% vs 36.0%, PFS: 233 days vs 99 days, OS: 587 days vs 558 days).

CONCLUSION

The primary endpoint of this study was not met. HAIC using percutaneous catheter placement techniques did not improve the RR for liver metastasis from CRC.

摘要

目的

本前瞻性多中心研究旨在评估经皮导管置入技术行肝动脉灌注化疗(HAIC)治疗结直肠癌(CRC)肝转移的疗效及不良事件。

方法

我们每周通过肝动脉灌注以1000mg/m²的剂量给予5-氟尿嘧啶,持续5小时。主要终点为总缓解率(RR)。次要终点为总生存期(OS)、无进展生存期(PFS)和毒性。

结果

2000年2月至2002年3月,77例符合条件的患者纳入本研究。经过中位26个治疗周期后,4例患者达到完全缓解,29例达到部分缓解,28例病情稳定,15例病情进展,1例患者状态未知。总RR为42.9%,疾病控制率(DCR)为79.2%。中位PFS和OS时间分别为203天和560天。最常见的3级或4级血液学和非血液学毒性为总胆红素水平升高(10.4%)和γ-谷氨酰转移酶水平升高(10.4%)。关于背景因素与治疗结果的关系,有和无肝外病变的患者之间DCR、RR、PFS和OS存在差异(DCR:86.5%对64%,RR:46.2%对36.0%,PFS:233天对99天,OS:587天对558天)。

结论

本研究未达到主要终点。采用经皮导管置入技术的HAIC未提高CRC肝转移的RR。

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