不可切除的多结直肠癌肝转移患者转化手术中 FOLFOXIRI 方案的临床影响。

Clinical Impact of FOLFOXIRI Aiming for Conversion Surgery in Unresectable Multiple Colorectal Liver Metastasis.

机构信息

Department of Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan

Department of Surgery, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.

出版信息

Anticancer Res. 2019 Sep;39(9):5089-5096. doi: 10.21873/anticanres.13703.

DOI:10.21873/anticanres.13703

PMID:31519620

Abstract

BACKGROUND/AIM: We evaluated the clinical impact of FOLFOXIRI regimen aiming for conversion surgery in patients with unresectable multiple colorectal liver metastasis (CRLM).

PATIENTS AND METHODS

A total of 42 patients with unresectable multiple CRLM who received chemotherapy with molecular agents were included in the analysis. The clinical results of FOLFOXIRI with other regimens were compared.

RESULTS

The total conversion rate of 42 unresectable CRLM was 48.1%, and conversion cases had a better prognosis. Clinicopathological characteristics of conversion cases were more frequent in FOLFOXIRI induction, liver limited disease and maximum diameter × number (MDN) over 70. FOLFOXIRI achieved a higher conversion rate compared to other regimens (72.2% vs. 37.5%, p=0.0334), and significantly reduced the medication period until conversion surgery (median 5.8 courses) with a higher tumour necrotic rate. Consequently, the overall survival of conversion cases with FOLFOXIRI was better than that with other regimens (p=0.0055).

CONCLUSION

FOLFOXIRI plus molecular agents might provide a higher probability of conversion surgery with a prognostic benefit.

摘要

背景/目的：我们评估了 FOLFOXIRI 方案在不可切除的多灶性结直肠癌肝转移（CRLM）患者中进行转化手术的临床影响。

患者和方法

共纳入 42 例接受分子靶向药物化疗的不可切除的多灶性 CRLM 患者进行分析。比较了 FOLFOXIRI 方案与其他方案的临床结果。

结果

42 例不可切除的 CRLM 的总转化率为 48.1%，转化病例的预后更好。转化病例的临床病理特征是在 FOLFOXIRI 诱导期、肝脏局限性疾病和最大直径×数量（MDN）超过 70 时更常见。与其他方案相比，FOLFOXIRI 方案的转化率更高（72.2%比 37.5%，p=0.0334），并且转化手术前的用药时间更短（中位数 5.8 个疗程），肿瘤坏死率更高。因此，FOLFOXIRI 方案治疗的转化病例的总体生存率优于其他方案（p=0.0055）。