Jankowski Maciej, Bratos Krystyna, Urbanowicz Tomasz
Clinical Oncology and Immuno-Oncology Department with Day Outpatient Sub-Department and Reception Unit of Greater Poland Cancer Centre, Poznan, Poland.
Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland.
Rep Pract Oncol Radiother. 2025 Aug 7;30(3):357-365. doi: 10.5603/rpor.106280. eCollection 2025.
The rising burden of colorectal cancer with a high prevalence of advanced stages of new-onset is reported worldwide. While applied, chemotherapy can extend patients' survival, and proper tailoring is paramount. Based on computed tomography results, the study aimed to point out potential prognostic factors of complete or partial response to the initial three months of chemotherapy in palliative colorectal (CRC) cancer.
There were 133 (82 (62%) male and 51 (38%) female) consecutive patients with a median age of 70 (64-74) years who underwent palliative treatment due to the advanced stage of oncological gastrointestinal tract disease between 2022-2024 at the Clinical Oncology and Immuno-Oncology Department. After propensity score matching, 83 (52 (63%) males) colorectal cancer (CRC) patients with a median age of 69 (64-74) years were enrolled in the retrospective analysis. The chemotherapy was based on computed tomography (CT) imaging confirming the end-stage cancer disease.
The multivariable model revealed chemotherapy combined with anti-epidermal growth factors receptor drug (EGFR-CTH) as the lone predictive factor for metastasis regression [odds ratio (OR): 3.59, 95% confidence interval (CI): 1.18-10.91, p = 0.024]. The receiver operating characteristic curve revealed a predictive value of EGFR-CTH with the area under the curve of 0.663, yielding a sensitivity of 58.1%, specificity of 72.5%, and precision of 0.694.
The EGFR-CTH protocol can be regarded as an effective palliative therapy for terminal colon and rectal cancer disease. The EGFR-CTH protocol contributes to 3.6 times higher probability of CT-proven tumor regression within three months of treatment. Large-volume studies are required to confirm the outcomes presented.
全球范围内报道了结直肠癌负担不断上升,新发病例中晚期患病率较高。虽然化疗可以延长患者生存期,但恰当的个性化治疗至关重要。基于计算机断层扫描结果,本研究旨在指出姑息性结直肠癌患者对初始三个月化疗完全或部分缓解的潜在预后因素。
2022年至2024年期间,在临床肿瘤学和免疫肿瘤学部门,有133例(82例(62%)男性和51例(38%)女性)连续患者因晚期胃肠道肿瘤疾病接受姑息治疗,中位年龄为70(64 - 74)岁。经过倾向得分匹配后,83例(52例(63%)男性)中位年龄为69(64 - 74)岁的结直肠癌患者纳入回顾性分析。化疗基于计算机断层扫描(CT)成像确诊为终末期癌症疾病。
多变量模型显示,化疗联合抗表皮生长因子受体药物(EGFR - CTH)是转移灶消退的唯一预测因素[比值比(OR):3.59,95%置信区间(CI):1.18 - 10.91,p = 0.024]。受试者工作特征曲线显示EGFR - CTH的预测价值,曲线下面积为〇.663,灵敏度为58.1%,特异性为72.5%,精确度为0.694。
EGFR - CTH方案可被视为晚期结肠癌和直肠癌疾病的有效姑息治疗方法。EGFR - CTH方案使治疗三个月内CT证实肿瘤消退的概率提高3.6倍。需要进行大规模研究以证实所呈现结果。