Department of Radiology, Zhejiang Cancer Hospital, Hangzhou.
Department of Interventional Radiology, The Cancer Hospital of Harbin Medical University, Harbin.
Anticancer Drugs. 2018 Nov;29(10):1021-1025. doi: 10.1097/CAD.0000000000000690.
The liver is the most common site of colorectal cancer metastases. The present study aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) with raltitrexed and oxaliplatin for colorectal liver metastases in a prospective, multicenter, single-arm trial conducted in 12 hospitals from different areas in China. A total of 90 patients with colorectal liver metastases were enrolled and treated by TACE with raltitrexed 4 mg and oxaliplatin 100 mg, followed by embolotherapy with 50 mg oxaliplatin and 5-20 ml lipiodol, administered every 28 days for four cycles. Patients were followed up every 3 months after the treatment and up to 12 months. The primary endpoint was time to progression. For the full analysis set (FAS), the median time to progression and overall survival were 9.1 and 17.8 months, respectively. The disease control rate in FAS was 71 (78.9%). Grade 3 or 4 adverse events were reported for 24 (26.7%) out of all 90 patients. Grade 3 thrombocytopenia, transglutaminase abnormality, and decreased neutrophil were observed in eight (8.9%), six (6.7%), and five (5.6%) patients, respectively. No unexpected adverse events or toxic deaths were observed. TACE with raltitrexed plus oxaliplatin is feasible, clinically beneficial, and well tolerated with low-grade toxicity for colorectal cancer patients with liver metastases.
肝脏是结直肠癌转移的最常见部位。本研究旨在评估在我国不同地区的 12 家医院进行的前瞻性、多中心、单臂试验中,用雷替曲塞和奥沙利铂进行肝动脉化疗栓塞(TACE)治疗结直肠癌肝转移的疗效和安全性。共纳入 90 例结直肠癌肝转移患者,采用 TACE 治疗,雷替曲塞 4mg,奥沙利铂 100mg,继以奥沙利铂 50mg 和 5-20ml 碘油栓塞治疗,每 28 天 1 次,共 4 个周期。患者在治疗后每 3 个月进行随访,随访时间长达 12 个月。主要终点为无进展生存期。在全分析集(FAS)中,中位无进展生存期和总生存期分别为 9.1 个月和 17.8 个月。FAS 的疾病控制率为 71(78.9%)。90 例患者中共有 24 例(26.7%)出现 3 级或 4 级不良事件。8 例(8.9%)患者出现 3 级血小板减少,6 例(6.7%)患者出现转谷氨酰胺酶异常,5 例(5.6%)患者出现中性粒细胞减少。未观察到预期外的不良事件或毒性死亡。雷替曲塞联合奥沙利铂 TACE 治疗结直肠癌肝转移患者是可行的、临床有益的,且毒性低,耐受性良好。