Effects of the number of neoadjuvant therapy cycles on clinical outcomes, safety, and survival in patients with metastatic colorectal cancer undergoing metastasectomy  

作　　者：YUNG-SUNG YEH HSIANG-LIN TSAI YEN-CHENG CHEN WEI-CHIH SU PO-JUNG CHEN TSUNG-KUN CHANG CHING-CHUN LI CHING-WEN HUANG JAW-YUAN WANG 

机构地区：[1]Division of Trauma and Surgical Critical Care,Department of Surgery,KaohsiungMedical University Hospital,Kaohsiung Medical University,Kaohsiung,Taiwan,China [2]Department of Emergency Medicine,Faculty of Post-Baccalaureate Medicine,College of Medicine,Kaohsiung Medical University,Kaohsiung,Taiwan,China [3]Graduate Institute of Injury Prevention and Control,College of Public Health,Taipei Medical University,Taipei,Taiwan,China [4]Division of Colorectal Surgery,Department of Surgery,Kaohsiung Medical University Hospital,Kaohsiung Medical University,Kaohsiung,Taiwan,China [5]Department of Surgery,Faculty of Medicine,College of Medicine,Kaohsiung Medical University,Kaohsiung,Taiwan,China [6]Graduate Institute of Clinical Medicine,College of Medicine,Kaohsiung Medical University,Kaohsiung,Taiwan,China [7]Department of Surgery,Faculty of Post-Baccalaureate Medicine,College of Medicine,Kaohsiung Medical University,Kaohsiung,Taiwan,China [8]Graduate Institute of Medicine,College of Medicine,Kaohsiung Medical University,Kaohsiung,Taiwan,China [9]Center for Cancer Research,Kaohsiung Medical University,Kaohsiung,Taiwan,China [10]Pingtung Hospital,Ministry of Health and Welfare,Pingtung,Taiwan,China

出　　处：《Oncology Research》2022年第2期65-76,共12页肿瘤学研究（英文）

基　　金：supported by grants through funding from the Ministry of Science and Technology(MOST 109-2314-B-037-046-MY3,MOST110-2314-B-037-097,MOST 111-2314-B-037-070-MY3,MOST 111-2314-B-037-049);the Ministry of Health and Welfare(MOHW111-TDU-B-221-114014);funded by the Health and Welfare Surcharge of on Tobacco Products,and the Kaohsiung Medical University Hospital(KMUH110-0R37,KMUH110-0R38,KMUH110-0M34,KMUH110-0M35,KMUH110-0M36,KMUH-DK(B)110004-3);KMU Center for Cancer Research(KMU-TC111A04-1);KMU Office for Industry-Academic Collaboration(S109036),Kaohsiung Medical University.

摘　　要：The controversial outcomes in patients with metastatic colorectal cancer(mCRC)highlight the need for developing effective systemic neoadjuvant treatment strategies to improve clinical results.The optimal treatment cycles in patients with mCRC for metastasectomy remain undefined.This retrospective study compared the efficacy,safety,and survival of cycles of neoadjuvant chemotherapy/targeted therapy for such patients.Sixty-four patients with mCRC who received neoadjuvant chemotherapy/targeted therapy following metastasectomy were enrolled between January 2018 and April 2022.Twenty-eight patients received 6 cycles of chemotherapy/targeted therapy,whereas 36 patients received≥7 cycles(median,13;range,7–20).Clinical outcomes,including response,progression-free survival(PFS),overall survival(OS),and adverse events,were compared between these two groups.Of the 64 patients,47(73.4%)were included in the response group,and 17(26.6%)were included in the nonresponse group.The analysis revealed chemotherapy/targeted therapy cycle and pretreatment serum carcinoembryonic antigen(CEA)level as independent predictors of the response as well as overall survival and chemotherapy/targeted therapy cycle as an independent predictor of progression(all p<0.05).Furthermore,our results revealed shorter operation time,lower estimated operative blood loss,higher response rate,lower progression rate,and higher survival rate in≥7 cycles of chemotherapy/targeted therapy group(all p<0.05),but no statistical differences in adverse events were observed between the two groups(all p>0.05).The median OS and PFS were 48 months(95%CI,40.855–55.145)and 28 months(95%CI,18.952–37.48)in the≥7-cycle group and 24 months(95%CI,22.038–25.962)and 13 months(95%CI,11.674–14.326)in the 6-cycle group,respectively(both p<0.001).The oncological outcomes in the≥7-cycle group were significantly better than those in the 6-cycle group,without significant increases in adverse events.However,prospective randomized trials are mandatory to confirm the

关 键 词：Metastatic colorectal cancer Neoadjuvant chemotherapy/targeted therapy Treatment cycles METASTASECTOMY 

分 类 号：R735.34[医药卫生—肿瘤]