Guo JH, Zhang HY, Gao S, Zhang PJ, Li XT, Chen H, Wang XD, Zhu X. Hepatic artery infusion with raltitrexed or 5-fluorouracil for colorectal cancer liver metastasis. World J Gastroenterol 2017; 23(8): 1406-1411 [PMID: 28293087 DOI: 10.3748/wjg.v23.i8.1406]
Corresponding Author of This Article
Xu Zhu, MD, Chief, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Interventional therapy, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142, China. drzhuxu@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jian-Hai Guo, Hang-Yu Zhang, Song Gao, Peng-Jun Zhang, Hui Chen, Xiao-Dong Wang, Xu Zhu, MD, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Interventional therapy, Peking University Cancer Hospital and Institute, Beijing 100142, China
Xiao-Ting Li, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, Beijing 100142, China
Author contributions: Guo JH and Zhu X designed the research; Zhang HY, Gao S, Zhang PJ and Chen H analyzed the data; Zhang HY wrote the paper; Wang XD and Zhu X critically revised the manuscript for important intellectual content; Guo JH and Zhang HY contributed equally to this work and should be considered co-first authors; all authors contributed to this manuscript.
Supported byCapital Medical Development and Scientific Research Fund, China, No. 2014-2-2154.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Beijing Cancer Hospital.
Informed consent statement: Informed consent was waived.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Xu Zhu, MD, Chief, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Interventional therapy, Peking University Cancer Hospital and Institute, 52 Fucheng Road, Haidian District, Beijing 100142, China. drzhuxu@163.com
Telephone: +86-10-88196330
Received: December 10, 2016 Peer-review started: December 12, 2016 First decision: December 19, 2016 Revised: December 29, 2016 Accepted: January 11, 2017 Article in press: January 11, 2017 Published online: February 28, 2017 Processing time: 77 Days and 19.4 Hours
Abstract
AIM
To evaluate the efficiency and safety of hepatic artery infusion chemotherapy (HAIC) using raltitrexed or 5-fluorouracil for colorectal cancer (CRC) liver metastasis (CRCLM).
METHODS
A retrospective analysis of patients with unresectable CRCLM who failed systemic chemotherapy and were subsequently treated with HAIC at our institute from May 2013 to April 2015 was performed. A total of 24 patients were treated with 5-fluorouracil, and 18 patients were treated with raltitrexed.
RESULTS
The median survival time (MST) from diagnosis of CRC was 40.8 mo in the oxaliplatin plus raltitrexed (TOMOX) arm and 33.5 mo in the oxaliplatin plus 5-fluorouracil (FOLFOX) arm (P = 0.802). MST from first HAIC was 20.6 mo in the TOMOX arm and 15.4 mo in the FOLFOX arm (P = 0.734). Median progression-free survival (PFS) from first HAIC was 4.9 mo and 6.6 mo, respectively, in the TOMOX arm and FOLFOX arm (P = 0.215). Leukopenia (P = 0.026) was more common in the FOLFOX arm, and hepatic disorder (P = 0.039) was more common in the TOMOX arm. There were no treatment-related deaths in the TOMOX arm and one treatment-related death in the FOLFOX arm. Analysis of prognostic factors indicated that response to HAIC was a significant factor related to survival.
CONCLUSION
No significant difference in survival was observed between the TOMOX and FOLFOX arms. HAIC treatment with either TOMOX or FOLFOX was demonstrated as an efficient and safe alternative choice.
Core tip: Our study shows that hepatic artery infusion chemotherapy (HAIC) with either TOMOX (oxaliplatin plus raltitrexed) or FOLFOX (oxaliplatin plus 5-fluorouracil) was proven to be an efficient and safe alternative choice for patients with chemotherapy refractory colorectal cancer liver metastasis and no significant difference in survival was found between these two treatments. Cox univariate analysis shows that response to HAIC was a significant predictive factor.
