Wang Shuai, Yin Chun Hui, Zhang Xin Yan, Shang Zhi Mei, Huang Li Min, Luo Nan, Wang An Quan, Dong Ling Ling, Liu Hong Xing, Zhu Jing Yan
Department of Laboratory, Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao, Weifang, People's Republic of China.
Department of Laboratory, Qingdao Cancer Institute, Qingdao, Weifang, People's Republic of China.
J Res Med Sci. 2019 Oct 25;24:92. doi: 10.4103/jrms.JRMS_879_16. eCollection 2019.
Colorectal cancer is one of the most common malignancies in the world, and about 25% of colorectal cancer patients present with colorectal cancer liver metastases (CRCLM) even at new diagnosis. The study was to evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) alternating with mFOLFOX6 in Chinese patients with unresectable CRCLM.
In this study, by combining the systemic and regional treatment, the resectability rate, overall survival, and progression-free survival were measured with addition of TACE. Included patients had Eastern Cooperative Oncology Group performance status 0-2. Sixty-two patients received mFOLFOX6 plus one TACE after 2 weeks of chemotherapy; after 2 weeks, the next periodical treatment repeated. Patients received operation when the liver metastases were converted to resectability or severe tumor-associated complications occurred.
We found that 28 patients (45.2%) patients received operation after the treatment of TACE combined with systemic chemotherapy. The median time from initial treatment to the operation was 6 months. The median follow-up period was 41 months in all the patients. The 3-year survival rate of resected patients and unresected patients was 54% and 17%, respectively. Post-TACE syndrome was the major adverse reaction (81%). Other adverse reactions were neutropenia, nausea, and neurotoxicity. No patient died of the adverse reactions. The resection rate was related to hepatic segments and vasculature involvement.
Taken together, TACE alternating with mFOLFOX6 has been proved to be safe and effective for CRCLM treatment to improve resection rate and prolong the survival time.
结直肠癌是世界上最常见的恶性肿瘤之一，约25%的结直肠癌患者即使在初诊时就已出现结直肠癌肝转移（CRCLM）。本研究旨在评估经动脉化疗栓塞术（TACE）与mFOLFOX6方案交替治疗不可切除的中国CRCLM患者的安全性和疗效。
在本研究中，通过联合全身和局部治疗，在加入TACE的情况下测量可切除率、总生存期和无进展生存期。纳入患者的东部肿瘤协作组体能状态为0 - 2级。62例患者在化疗2周后接受mFOLFOX6加一次TACE治疗；2周后重复下一期治疗。当肝转移灶转为可切除或出现严重的肿瘤相关并发症时，患者接受手术。
我们发现28例（45.2%）患者在TACE联合全身化疗治疗后接受了手术。从初始治疗到手术的中位时间为6个月。所有患者的中位随访期为41个月。接受手术患者和未接受手术患者的3年生存率分别为54%和17%。TACE术后综合征是主要不良反应（81%）。其他不良反应为中性粒细胞减少、恶心和神经毒性。无患者死于不良反应。切除率与肝段及血管受累情况有关。
综上所述，TACE与mFOLFOX6方案交替治疗CRCLM已被证明是安全有效的，可提高切除率并延长生存时间。
