Hepatic Arterial Infusion Chemotherapy With Folfirinox or Oxaliplatin Alone in Metastatic Colorectal Cancer

Frontiers in Medicine

卷:9

Edouard Auclin²  Rosine Guimbaud³  Pascale Rivera³  Annie Lim⁴  Claire Gallois⁵  Julien Taieb⁵  Violaine Randrian⁶  Yann Touchefeu⁷  Simon Pernot⁸  Sahir Javed⁹  Anthony Turpin⁹  Mehdi Karoui¹⁰  Denis Smith¹¹  Baptiste Sionneau¹¹ 

[1] 0Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Bourgogne Franche-Comté University, INSERM, EFS BFC, UMR 1098, Interactions Hôte-Greffon-Tumeur/Ingénierie Cellulaire et Génique, Besançon, France;

[2] 1Department of Medical Oncology, Université de Paris, Hôpital Européen Georges Pompidou, Paris, France;

[3] Department of Digestive Oncology, IUCT-Rangueil, CHU Toulouse, Toulouse, France;

[4] Department of Gastroenterology, Clinique Santé Atlantique, Saint-Herblain, France;

[5] Department of Gastrointestinal Oncology, Université de Paris, Hôpital Européen Georges Pompidou, Paris, France;

[6] Department of Hepato-Gastro-Enterology, CHU Poitiers, Poitiers, France;

[7] Department of Hepatogastroenterology, Digestive Oncology, Nantes University Hospital, Nantes, France;

[8] Department of Medical Oncology, Institut Bergonié, Bordeaux, France;

[9] Department of Oncology, CHU Lille, Lille, France;

[10] Department of Surgical Oncology, Université de Paris, Hôpital Européen Georges Pompidou, Paris, France;

[11] Medical Oncology, Bordeaux University Hospital, Bordeaux, France;

关键词: colorectal cancer;    hepatic arterial infusion;    liver metastases;    cancer treatment;    surgery;   

DOI  :  10.3389/fmed.2022.830595

来源: DOAJ

【 摘 要 】

BackgroundHepatic arterial infusion (HAI) of chemotherapy is an option for the treatment of patients with liver metastases from colorectal cancer (LMCRC). Though HAI with oxaliplatin (HAI-Ox) is generally used, intravenous (IV) 5-fluoro-uracil (5FU)-oxaliplatin-irinotecan HAI (HAI-Folfirinox) is feasible and leads to curative-intent surgery in 30% of pretreated patients. We compared the efficacy and safety of HAI-Ox and HAI-Folfirinox.MethodsPatients who underwent HAI chemotherapy for LMCRC were retrospectively included from 2008 to 2019 from six French expert centers.ResultsData were collected from 273 previously treated patients with LMCRC. Patients received HAI-Folfirinox (n = 52) or HAI-Ox (n = 221) combined with IV chemotherapy. The objective response rate (ORR) was 43.2% in patients with HAI-Folfirinox and 45.9% (ns) in patients with HAI-Ox. Median overall survival (OS) was 17 months (95% CI: 15–32.3) with HAI-Folfirinox and 26.2 months (95% CI: 19.4–34.4; p = 0.1) with HAI-Ox. Median progression-free survival (PFS) was 7.9 months (95% CI: 4.9–10.3) with HAI-Folfirinox and 6.4 months (95% CI: 6.0–7.7; p = 0.6) with HAI-Ox. The secondary liver resection rate was 35.6% with HAI-Folfirinox and 16.7% with HAI-Ox (p = 0.007). Grade 2 and above toxicities were significantly more frequent with HAI-Folfirinox. In the global population, only 2 factors were prognostic for OS in multivariable analyses: liver-only disease [hazard ratio (HR): 0.4; 95% CI 0.20–0.83; p = 0.013] and local complications of the catheter (HR: 3.8; 95% CI 1.6–9.0; p = 0.002).ConclusionHepatic arterial infusion results in high response rates, secondary resections, and long survival in pretreated patients with LMCRC.

【 授权许可】

Unknown