Triplet therapy with oxaliplatin, irinotecan, 5-fluorouracil and folinic acid within a combined modality approach in patients with liver metastases from colorectal cancer
2004; Lippincott Williams & Wilkins; Volume: 22; Issue: 14_suppl Linguagem: Inglês
10.1200/jco.2004.22.14_suppl.3593
ISSN1527-7755
AutoresJ. De La Cámara, Javier Rodríguez, Fernando Rotellar, A. Viúdez, Jesús García‐Foncillas, F. Pardo, Ignacio Gil‐Bazo, Á. Chopitea, Salvador Martín‐Algarra,
Tópico(s)Lung Cancer Treatments and Mutations
Resumo3593 Background: Although surgical resection remains the treatment of choice for liver metastases from colorectal cancer, only a minority of pts are suitable for surgery. Preoperative chemotherapy allows secondary liver resection and subsequent long-term survival in some patients (pts)with unresectable CCR liver metastases Methods: The aim of this study was to evaluate the safety and efficacy of oxaliplatin 120 mg/m2 day 1, CPT-11 150 mg/m2 day 1 and 14, fluorouracil 2600 mg/m2 days 1 and 14 and folinic acid 500 mg/m2 days 1 and 14, every four weeks, in metastasic liver CCR patients either technically unresectable or with known poor prognostic factors for long term survival after surgery. Results: 39 pts (M/F: 30/9), median age 55 (28–77), median ECOG 1 (0–2) were included. Mean number of liver nodes and mean size were 6.7 and 6.1 cm, respectively. 22 pts (56.4%) were initially unresectable while 17 (43.6%) had poor prognostic factors including large tumor size (52.9%), multinodular (23.5%), ill-located (23.5) and/or bilobar metastases (35.3%).Overall response rate to induction chemotherapy was 64%, 3 pts (7.7%) progressed while on-therapy. 23 pts underwent secondary surgery, including hepatectomy (52.2%) and wedge resections (47.8%), with (n=10) or without radiofrequency. An R0 resection was achieved in 84 % of pts, with margins <1cm in 60.9% of them. Pathological complete response rate was 17.4%. After neoadyuvant chemotherapy, 11 out of 22 initially unresectable CCR pts underwent surgery with curative intent, including 9 of then with a R0 resection. After a median follow up of 15 months (4–40), median progression-free survival and overall survival have not been reached. Main grade 3–4 toxicity included anemia (7.7%), leucopenia (13.9%), neutropenia (30.8%), plaquetopenia (5.1%), vomiting (5.1%) and diarrhea (23%) 1 pt died due to postoperative complications. Conclusions: Induction therapy with this triplet regimen achieves a high resectability and pathological complete response rates. No significant financial relationships to disclose.
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