The combination of systemic chemotherapy and local treatment may improve the survival of patients with unresectable metastatic colorectal cancer

Zhao,Jiemin; Shi,Liangrong; Ji,Mei; Wu,Jun; Wu,Changping

doi:10.3892/mco.2017.1247

The combination of systemic chemotherapy and local treatment may improve the survival of patients with unresectable metastatic colorectal cancer

Authors:
- Jiemin Zhao
- Liangrong Shi
- Mei Ji
- Jun Wu
- Changping Wu
View Affiliations

Affiliations: Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu 213000, P.R. China
Published online on: May 8, 2017 https://doi.org/10.3892/mco.2017.1247
Pages: 856-860
Copyright: © Zhao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

With the development of systemic chemotherapy, the survival time of patients with advanced colorectal cancer (CRC) has increased. In addition, local treatments, such as microwave ablation and radioactive seed implantation, have been shown to be effective. However, the number of studies reporting on the effect of systemic chemotherapy combined with local treatments is limited. The present study was conducted to determine the effect of local treatment combined with systemic chemotherapy in patients with initial unresectable metastatic CRC (mCRC). Clinicopathological and follow‑up data from 273 patients with initial unresectable mCRC between April, 2007 and October, 2013 were retrospectively analyzed. A total of 51 patients received minimally invasive treatments combined with systemic chemotherapy and 39 patients achieved tumor‑free survival (TFS). The median TFS time was 9 months (range, 2‑45 months); the median overall survival (OS) time was 40 months (range, 12‑108 months). In patients who did not achieve TFS, the OS was 37 months. Thus, patients who achieved TFS exhibited a significantly longer OS compared with those who did not achieve TFS (P=0.049). The results of the univariate analysis demonstrated that certain characteristics, such as the number of lesions and maximum tumor diameter, were associated with the achievement of TFS. The patients assessed herein achieved TFS in response to local treatments combined with systemic chemotherapy. Furthermore, the achieved TFS provided an OS benefit.

View Figures

View References

1	Mayo SC and Pawlik TM: Current management of colorectal hepatic metastasis. Expert Rev Gastroenterol Hepatol. 3:131–144. 2009. View Article : Google Scholar : PubMed/NCBI
2	Ye LC, Liu TS, Ren L, Wei Y, Zhu DX, Zai SY, Ye QH, Yu Y, Xu B, Qin XY and Xu J: Randomized controlled trial of cetuximab plus chemotherapy for patients with KRAS wild- type unresectable colorectal liver-limited metastases. J Clin Oncol. 31:1931–1938. 2013. View Article : Google Scholar : PubMed/NCBI
3	Morris EJ, Forman D, Thomas JD, Quirke P, Taylor EF, Fairley L, Cottier B and Poston G: Surgical management and outcomes of colorectal cancer liver metastases. Br J Surg. 97:1110–1118. 2010. View Article : Google Scholar : PubMed/NCBI
4	Folprecht G, Gruenberger T, Bechstein W, Raab HR, Weitz J, Lordick F, Hartmann JT, Stoehlmacher-Williams J, Lang H, Trarbach T, et al: Survival of patients with initially unresectable colorectal liver metastases treated with FOLFOX/cetuximab or FOLFIRI/cetuximab in a multidisciplinary concept (CELIM study). Ann Oncol. 25:1018–1025. 2014. View Article : Google Scholar : PubMed/NCBI
5	Formica V and Roselli M: Targeted therapy in first line treatment of RAS wild type colorectal cancer. World J Gastroenterol. 21:2871–2874. 2015. View Article : Google Scholar : PubMed/NCBI
6	Tournigand C, André T, Achille E, Lledo G, Flesh M, Mery-Mignard D, Quinaux E, Couteau C, Buyse M, Ganem G, et al: FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: A randomized GERCOR study. J Clin Oncol. 22:229–237. 2004. View Article : Google Scholar : PubMed/NCBI
7	Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, et al: New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer. 45:228–247. 2009. View Article : Google Scholar : PubMed/NCBI
8	Shi L, Wu C, Wu J, Zhou W, Ji M, Zhang H, Zhao J, Huang Y, Pei H, Li Z, et al: Computed tomography-guided permanent brachytherapy for locoregional recurrent gastric cancer. Radiat Oncol. 7:1142012. View Article : Google Scholar : PubMed/NCBI
9	Shi L, Li X, Pei H, Zhao J, Qiang W, Wang J, Xu B, Chen L, Wu J, Ji M, et al: Phase II study of computed tomography-guided (125)I-seed implantation plus chemotherapy for locally recurrent rectal cancer. Radiother Oncol. 118:375–381. 2016. View Article : Google Scholar : PubMed/NCBI
10	Shi L, Chen L, Wu C, Zhu Y, Xu B, Zheng X, Sun M, Wen W, Dai X, Yang M, et al: PD-1 blockade boosts radiofrequency ablation-elicited adaptive immune responses against tumor. Clin Cancer Res. 22:1173–1184. 2016. View Article : Google Scholar : PubMed/NCBI
11	Shi L, Zhao J, Lu Q, Chen X, Wang H, Jiang Y, Wu J, Ji M, Xu B, Chen L, et al: Initial hepatic artery infusion and systemic chemotherapy for asymptomatic colorectal cancer with un-resectable liver metastasis. Int J Clin Exp Med. 8:1000–1008. 2015.PubMed/NCBI
12	Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T and Thun M: Cancer statistics, 2008. CA Cancer J Clin. 58:71–96. 2008. View Article : Google Scholar : PubMed/NCBI
13	Skitzki JJ and Chang AE: Hepatic artery chemotherapy for colorectal liver metastases: Technical considerations and review of clinical trials. Surg Oncol. 11:123–135. 2002. View Article : Google Scholar : PubMed/NCBI
14	Eng OS, Tsang AT, Moore D, Chen C, Narayanan S, Gannon CJ, August DA, Carpizo DR and Melstrom LG: Outcomes of microwave ablation for colorectal cancer liver metastases: A single center experience. J Surg Oncol. 111:410–413. 2015. View Article : Google Scholar : PubMed/NCBI
15	Wang Z, Lu J, Liu L, Liu T, Chen K, Liu F and Huang G: Clinical application of CT-guided (125)I seed interstitial implantation for local recurrent rectal carcinoma. Radiat Oncol. 6:1382011. View Article : Google Scholar : PubMed/NCBI
16	Van Loon K and Venook AP: Curable patient with metastatic colorectal cancer: Balancing effective therapies and toxicities. J Clin Oncol. 32:991–996. 2014. View Article : Google Scholar : PubMed/NCBI
17	Venderbosch S, de Wilt JH, Teerenstra S, Loosveld OJ, van Bochove A, Sinnige HA, Creemers GJ, Tesselaar ME, Mol L, Punt CJ and Koopman M: Prognostic value of resection of primary tumor in patients with stage IV colorectal cancer: Retrospective analysis of two randomized studies and a review of the literature. Ann Surg Oncol. 18:3252–3260. 2011. View Article : Google Scholar : PubMed/NCBI
18	Tournigand C, Samson B, Scheithauer W, Lledo G, Viret F, Andre T, Ramée JF, Tubiana-Mathieu N, Dauba J, Dupuis O, et al: Bevacizumab (Bev) with or without erlotinib as maintenance therapy, following induction first-line chemotherapy plus Bev, in patients with metastatic colorectal cancer (mCRC): Efficacy and safety results of the international GERCOR DREAM phase III trial. J Clin Oncol. 30(suppl): S35002012. View Article : Google Scholar
19	Yalcin S, Uslu R, Dane F, Yilmaz U, Zengin N, Buyukunal E, Buyukberber S, Camci C, Sencan O, Kilickap S, et al: Bevacizumab+ capecitabine as maintenance therapy after initial bevacizumab+ XELOX treatment in previously untreated patients with metastatic colorectal cancer: Phase III ‘stop and go’ study results-a Turkish oncology group trial. Oncology. 85:328–335. 2013. View Article : Google Scholar : PubMed/NCBI
20	Petre EN, Jia X, Thornton RH, Sofocleous CT, Alago W, Kemeny NE and Solomon SB: Treatment of pulmonary colorectal metastases by radiofrequency ablation. Clin Colorectal Cancer. 12:37–44. 2013. View Article : Google Scholar : PubMed/NCBI
21	Zhou P, Liang P, Dong B, Yu X, Han Z and Xu Y: Phase I clinical study of combination therapy with microwave ablation and cellular immunotherapy in hepatocellular carcinoma. Cancer Biol Ther. 11:450–456. 2011. View Article : Google Scholar : PubMed/NCBI
22	Wang J, Yuan H and Liu J: The effects of CT guided interstitial 125I seed implantation in the treatment of recurrent colorectal cancer. J Chin Radiation Oncol. 15:319–322. 2006.
23	Tournigand C, Cervantes A, Figer A, Lledo G, Flesch M, Buyse M, Mineur L, Carola E, Etienne PL, Rivera F, et al: OPTIMOX1: A randomized study of FOLFOX4 or FOLFOX7 with oxaliplatin in a stop-and-Go fashion in advanced colorectal cancer-a GERCOR study. J Clin Oncol. 24:394–400. 2006. View Article : Google Scholar : PubMed/NCBI