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

Frontiers in Medicine

article

Violaine Randrian¹  Simon Pernot²  Baptiste Sionneau³  Denis Smith³  Annie Lim⁴  Yann Touchefeu⁵  Claire Gallois⁶  Anthony Turpin⁷  Sahir Javed⁷  Rosine Guimbaud⁸  Pascale Rivera⁸  Mehdi Karoui⁹  Edouard Auclin^1,10  Julien Taieb⁶ 

[1] Department of Hepato-Gastro-Enterology;Department of Medical Oncology, Institut Bergonié;Medical Oncology, Bordeaux University Hospital;Department of Gastroenterology;Department of Hepatogastroenterology, Digestive Oncology, Nantes University Hospital;Department of Gastrointestinal Oncology, Université de Paris, Hôpital Européen Georges Pompidou;Department of Oncology;Department of Digestive Oncology;Department of Surgical Oncology, Université de Paris, Hôpital Européen Georges Pompidou;Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Bourgogne Franche-Comté University;Department of Medical Oncology, Université de Paris, Hôpital Européen Georges Pompidou

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

DOI  :  10.3389/fmed.2022.830595

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background Hepatic 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. Methods Patients who underwent HAI chemotherapy for LMCRC were retrospectively included from 2008 to 2019 from six French expert centers. Results Data 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). Conclusion Hepatic arterial infusion results in high response rates, secondary resections, and long survival in pretreated patients with LMCRC.

【 授权许可】

CC BY