Neoadjuvant treatment of unresectable liver disease with irinotecan and 5-fluorouracil plus folinic acid in colorectal cancer patients

Alessandra Cassano, Maria Vellone, Felice Giuliante, Gennaro Nuzzo, Carmelo Pozzo, Michele Basso, Michela Quirino, Giovanni Schinzari, Nunziatina Trigila, Carlo Antonio Barone

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

275 Citazioni (Scopus)

Abstract

Background: The aim of this study was to observe the effects of neoadjuvant therapy with irinotecan and 5-fluorouracil (5-FU)/folinic acid (FA) on the resection rate and survival of colorectal cancer patients with initially unresectable hepatic metastases. Patients and methods: Forty patients received neoadjuvant chemotherapy comprising irinotecan 180 mg/m(2) administered intravenously (i.v.) on day 1, FA 200 mg/m(2) i.v. on days I and 2, 5-FU 400 mg/m(2) i.v. bolus on days I and 2, and 5-FU 1200 mg/m(2) as a continuous 48-h i.v. infusion on day 1. The treatment was repeated every 2 weeks and response was assessed every 12 weeks (six cycles). Results: The objective response rate to chemotherapy was 47.5% (it = 19), with two complete responses and disease stabilization in H (27.5.%) patients. Responses were unconfirmed for I I patients undergoing surgery within 2 weeks. Treatment was well tolerated and adverse events were typical of the chemotherapy agents used. Twenty-seven (67.5%) patients reported hematological toxicity (35.0% grade 3/4) and 14 (35.0%) reported gastrointestinal toxicity (12.5% grade 3/4). Thirteen patients (32.5%) underwent potentially curative liver resection following chemotherapy. Chemotherapy was particularly effective in patients with large metastases on entry to the study. The median time to progression is 14.3 months and, at a median follow-up of 19 months, all patients are alive. Conclusions: Neoadjuvant therapy with irinotecan combined with 5-FU/FA enabled a significant proportion of patients with initially unresectable liver metastases to undergo surgical resection. The effects of treatment on survival have yet to be determined.
Lingua originaleEnglish
pagine (da-a)933-939
Numero di pagine7
RivistaAnnals of Oncology
Volume15
DOI
Stato di pubblicazionePubblicato - 2004

Keywords

  • Colorectal cancer
  • Fluorouracil
  • Folinic acid
  • Irinotecan
  • Liver metastases
  • Unresectable disease

Fingerprint Entra nei temi di ricerca di 'Neoadjuvant treatment of unresectable liver disease with irinotecan and 5-fluorouracil plus folinic acid in colorectal cancer patients'. Insieme formano una fingerprint unica.

Cita questo