Guo Jian-Hai, Zhang Hang-Yu, Gao Song, Zhang Peng-Jun, Li Xiao-Ting, Chen Hui, Wang Xiao-Dong, Zhu Xu
Jian-Hai Guo, Hang-Yu Zhang, Song Gao, Peng-Jun Zhang, Hui Chen, MD, Xiao-Dong Wang, Xu Zhu, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Interventional therapy, Peking University Cancer Hospital and Institute, Beijing 100142, China.
World J Gastroenterol. 2017 Feb 28;23(8):1406-1411. doi: 10.3748/wjg.v23.i8.1406.
To evaluate the efficiency and safety of hepatic artery infusion chemotherapy (HAIC) using raltitrexed or 5-fluorouracil for colorectal cancer (CRC) liver metastasis (CRCLM).
A retrospective analysis of patients with unresectable CRCLM who failed systemic chemotherapy and were subsequently treated with HAIC at our institute from May 2013 to April 2015 was performed. A total of 24 patients were treated with 5-fluorouracil, and 18 patients were treated with raltitrexed.
The median survival time (MST) from diagnosis of CRC was 40.8 mo in the oxaliplatin plus raltitrexed (TOMOX) arm and 33.5 mo in the oxaliplatin plus 5-fluorouracil (FOLFOX) arm ( = 0.802). MST from first HAIC was 20.6 mo in the TOMOX arm and 15.4 mo in the FOLFOX arm ( = 0.734). Median progression-free survival (PFS) from first HAIC was 4.9 mo and 6.6 mo, respectively, in the TOMOX arm and FOLFOX arm ( = 0.215). Leukopenia ( = 0.026) was more common in the FOLFOX arm, and hepatic disorder ( = 0.039) was more common in the TOMOX arm. There were no treatment-related deaths in the TOMOX arm and one treatment-related death in the FOLFOX arm. Analysis of prognostic factors indicated that response to HAIC was a significant factor related to survival.
No significant difference in survival was observed between the TOMOX and FOLFOX arms. HAIC treatment with either TOMOX or FOLFOX was demonstrated as an efficient and safe alternative choice.
评估雷替曲塞或5-氟尿嘧啶肝动脉灌注化疗（HAIC）用于结直肠癌（CRC）肝转移（CRCLM）的有效性和安全性。
对2013年5月至2015年4月在我院接受HAIC治疗的不可切除CRCLM患者进行回顾性分析，这些患者均接受过全身化疗且治疗失败。共有24例患者接受5-氟尿嘧啶治疗，18例患者接受雷替曲塞治疗。
从结直肠癌诊断开始计算，奥沙利铂联合雷替曲塞（TOMOX）组的中位生存时间（MST）为40.8个月，奥沙利铂联合5-氟尿嘧啶（FOLFOX）组为33.5个月（P = 0.802）。从首次HAIC开始计算，TOMOX组的MST为20.6个月，FOLFOX组为15.4个月（P = 0.734）。TOMOX组和FOLFOX组从首次HAIC开始计算的中位无进展生存期（PFS）分别为4.9个月和6.6个月（P = 0.215）。白细胞减少症（P = 0.026）在FOLFOX组中更常见，肝脏疾病（P = 0.039）在TOMOX组中更常见。TOMOX组无治疗相关死亡，FOLFOX组有1例治疗相关死亡。预后因素分析表明，对HAIC的反应是与生存相关的重要因素。
TOMOX组和FOLFOX组在生存方面未观察到显著差异。TOMOX或FOLFOX的HAIC治疗均被证明是一种有效且安全的替代选择。
