射频消融先后顺序对XELOX方案治疗结直肠癌肝转移患者安全性和预后的影响

丁晓燕; 陈京龙; 孙巍; 李文东; 郭晓笛; 申燕军; 孙莎莎; 庄秀芬

doi:10.3969/j.issn.1001-5256.2018.12.019

射频消融先后顺序对XELOX方案治疗结直肠癌肝转移患者安全性和预后的影响

DOI: 10.3969/j.issn.1001-5256.2018.12.019

1. 首都医科大学附属北京地坛医院肿瘤内科
2. 江苏大学附属医院化疗科

基金项目:

国家自然科学基金青年基金(1721280028)；

详细信息

中图分类号: R735.34
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出版历程
- 出版日期: 2018-12-20

Influence of time schedule of radiofrequency ablation on the safety and prognosis of patients with colorectal cancer liver metastasis receiving XELOX regimen: A single-center clinical study

Research funding:

摘要

摘要: 目的探讨在射频消融（RFA）联合XELOX方案治疗结直肠癌肝转移患者过程中,RFA不同时间顺序对于患者安全性和预后的影响。方法回顾性分析北京地坛医院2011年1月-2017年8月RFA联合XELOX方案治疗结直肠癌肝转移的患者48例,依据RFA的时间顺序分为2组,一组为RFA序贯全身化疗±靶向治疗（A组,n=25）,另一组为先化疗±靶向治疗后RFA（B组,n=23）;疾病稳定或部分缓解患者继续口服希罗达直至疾病进展或副反应不可耐受。主要观察终点为肿瘤客观缓解率,次要观察终点为疾病进展时间（TTP）、总生存期（OS）和安全性。结果 A组肿瘤客观缓解率（68. 0%,其中CR 8例、PR 9例）与B组（43. 5%,其中CR 2例、PR 8例）差异无统计学意义（χ2=2. 927,P=0. 087）。A组和B组中位TTP分别为9. 0个月和8. 0个月,中位OS分别为33个月和30个月,2组间差异均无统计学意义（χ2值分别为2. 660、0. 562,P值均> 0. 05）。对于单纯肝转移患者,A组和B组中位TTP分别为15. 0个月和8. 0个月,差异有统计学意义（χ2=4. 33...
- 肿瘤转移 /
- 结直肠肿瘤 /
- 导管消融术 /
- 药物疗法,联合
Abstract: Objective To investigate the influence of time schedule of radiofrequency ablation (RFA) on the safety and prognosis of patients with colorectal cancer liver metastasis treated with RFA combined with XELOX regimen. Methods A retrospective analysis was performed for the clinical data of 48 patients with colorectal cancer liver metastasis who received RFA combined with XELOX regimen in Beijing Ditan Hospital from January 2011 to August 2017, and according to the time schedule of RFA, these patients were divided into group A (25 patients treated with RFA and sequential systemic chemotherapy ± targeted therapy) and group B (23 patients treated with chemotherapy ±targeted therapy and then RFA) . The patients with a stable disease or partial remission continued to take Xeloda orally until disease progression or intolerable side effects. The primary endpoint was objective response rate (ORR) of tumor, and the secondary endpoints included time to progression (TTP) , overall survival (OS) , and safety. Results There was no significant difference in ORR between group A and group B [68. 0% (8 patients with complete response and 9 with partial response) vs 43. 5% (2 patients with complete response and 9 with partial response) , χ2= 2. 927, P = 0. 087]. There were no significant differences between group A and group B in median TTP (9. 0 months vs 8. 0 months, χ2= 2. 660, P > 0. 05) and median OS (33 months vs 30 months, χ2= 0. 562, P > 0. 05) . For the patients with liver metastasis alone, there was a significant difference in median TTP between group A and group B (15. 0 months vs 8. 0 months, χ2= 4. 331, P = 0. 037) . Both groups had similar incidence and degree of common adverse events (AEs) (all P > 0. 05) . Most treatment-related AEs were mild or moderate; the most common mild AE (grade I/II) was leucopenia (93. 8%) , followed by nausea (91. 7%) and abdominal pain (81. 3%) . There were no fatal AEs, and the most common grade III/IV treatment-related AE was hematological toxicity observed in14 patients (29. 2%) . All AEs were resolved without sequelae. Conclusion RFA combined with XELOX-Xeloda maintenance chemotherapy is well tolerated and has a good clinical effect in patients with colorectal cancer liver metastasis. For patients with liver metastasis alone, RFA followed by chemotherapy can improve ORR of tumor.
- neoplasm metastasis /
- colorectal neoplasms /
- catheter ablation /
- drug therapy, combination

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