Short-term outcomes of neoadjuvant chemotherapy in colorectal cancer patients with isolated liver metastasis
The purpose of the study was to assess the short-term effcacy and tolerability of neoadjuvant chemotherapy (NAC) in colorectal cancer (CRC) patients with isolated liver metastasis.Material and Methods. Since 2020, a pilot study including 23 CRC patients with liver metastasis has been conducted at th...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | Russian |
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Russian Academy of Sciences, Tomsk National Research Medical Center
2023-01-01
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| Series: | Сибирский онкологический журнал |
| Subjects: | |
| Online Access: | https://www.siboncoj.ru/jour/article/view/2367 |
| _version_ | 1826563645718396928 |
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| author | A. Yu. Dobrodeev D. N. Kostromitsky A. S. Tarasova S. G. Afanasyev N. N. Babyshkina A. A. Ponomaryeva R. V. Ermolenko I. G. Frolova O. V. Cheremisina |
| author_facet | A. Yu. Dobrodeev D. N. Kostromitsky A. S. Tarasova S. G. Afanasyev N. N. Babyshkina A. A. Ponomaryeva R. V. Ermolenko I. G. Frolova O. V. Cheremisina |
| author_sort | A. Yu. Dobrodeev |
| collection | DOAJ |
| description | The purpose of the study was to assess the short-term effcacy and tolerability of neoadjuvant chemotherapy (NAC) in colorectal cancer (CRC) patients with isolated liver metastasis.Material and Methods. Since 2020, a pilot study including 23 CRC patients with liver metastasis has been conducted at the Abdominal Cancer Department of the Cancer Research Institute (Tomsk, Russia). The combined treatment modality included 3 cycles of NAC according to FOLFOXIRI + cetuximab (20 patients with wtKRAS) and FOLFOXIRI + bevacizumab (3 patients with mtKRAS) regimens followed by simultaneous laparoscopic colorectal resection and open liver resection.Results. For liver metastases, the objective response rate reached 100 % (complete response: 8.7 %, partial response: 91.3 %). For the primary tumor, the objective response rate was 100 % (partial response). The overall NAC toxicity rate was 53.6 %. The major I–II grade toxicities included nausea/vomiting (27.5 %), polyneuropathy (10.1 %), skin reaction (10.1 %), hepatotoxicity (5.8 %), and corresponded to I–II grade. R0 resection was performed in all patients. Postoperative complications were observed in 19 (82.6 %) patients; of them 18 (78.3 %) had a febrile temperature (grade 1, according to the Clavien–Dindo classifcation) due to the use of bipolar coagulation during liver surgery, and 1 (4.4 %) patient developed a biliary fstula (3 A/B grade according to Clavien–Dindo). No postoperative death occurred. For liver metastasis, pathological complete response rate was 4.4 % (TRG1 according to Mandard); for the primary tumor, in most cases was TRG 3 – 87 %.Conclusion. Combined treatment modality, including NAC with FOLFOXIRI regimen and targeted therapy for CRC with liver metastases, is well tolerated, has a signifcant damaging effect on the tumor, and does not affect the course of the postoperative period. Further studies are required to assess the long-term treatment outcomes. |
| first_indexed | 2024-04-10T01:51:39Z |
| format | Article |
| id | doaj.art-efd9630d7f6f4c30b2eb184d1b6857f1 |
| institution | Directory Open Access Journal |
| issn | 1814-4861 2312-3168 |
| language | Russian |
| last_indexed | 2025-03-14T10:07:16Z |
| publishDate | 2023-01-01 |
| publisher | Russian Academy of Sciences, Tomsk National Research Medical Center |
| record_format | Article |
| series | Сибирский онкологический журнал |
| spelling | doaj.art-efd9630d7f6f4c30b2eb184d1b6857f12025-03-02T11:16:17ZrusRussian Academy of Sciences, Tomsk National Research Medical CenterСибирский онкологический журнал1814-48612312-31682023-01-01216172410.21294/1814-4861-2022-21-6-17-241059Short-term outcomes of neoadjuvant chemotherapy in colorectal cancer patients with isolated liver metastasisA. Yu. Dobrodeev0D. N. Kostromitsky1A. S. Tarasova2S. G. Afanasyev3N. N. Babyshkina4A. A. Ponomaryeva5R. V. Ermolenko6I. G. Frolova7O. V. Cheremisina8Cancer Research Institute, Тomsk National Research Medical Center, Russian Academy of SciencesCancer Research Institute, Тomsk National Research Medical Center, Russian Academy of SciencesCancer Research Institute, Тomsk National Research Medical Center, Russian Academy of SciencesCancer Research Institute, Тomsk National Research Medical Center, Russian Academy of SciencesCancer Research Institute, Тomsk National Research Medical Center, Russian Academy of Sciences; Siberian State Medical University of the Ministry of Health of RussiaCancer Research Institute, Тomsk National Research Medical Center, Russian Academy of SciencesCancer Research Institute, Тomsk National Research Medical Center, Russian Academy of SciencesCancer Research Institute, Тomsk National Research Medical Center, Russian Academy of SciencesCancer Research Institute, Тomsk National Research Medical Center, Russian Academy of SciencesThe purpose of the study was to assess the short-term effcacy and tolerability of neoadjuvant chemotherapy (NAC) in colorectal cancer (CRC) patients with isolated liver metastasis.Material and Methods. Since 2020, a pilot study including 23 CRC patients with liver metastasis has been conducted at the Abdominal Cancer Department of the Cancer Research Institute (Tomsk, Russia). The combined treatment modality included 3 cycles of NAC according to FOLFOXIRI + cetuximab (20 patients with wtKRAS) and FOLFOXIRI + bevacizumab (3 patients with mtKRAS) regimens followed by simultaneous laparoscopic colorectal resection and open liver resection.Results. For liver metastases, the objective response rate reached 100 % (complete response: 8.7 %, partial response: 91.3 %). For the primary tumor, the objective response rate was 100 % (partial response). The overall NAC toxicity rate was 53.6 %. The major I–II grade toxicities included nausea/vomiting (27.5 %), polyneuropathy (10.1 %), skin reaction (10.1 %), hepatotoxicity (5.8 %), and corresponded to I–II grade. R0 resection was performed in all patients. Postoperative complications were observed in 19 (82.6 %) patients; of them 18 (78.3 %) had a febrile temperature (grade 1, according to the Clavien–Dindo classifcation) due to the use of bipolar coagulation during liver surgery, and 1 (4.4 %) patient developed a biliary fstula (3 A/B grade according to Clavien–Dindo). No postoperative death occurred. For liver metastasis, pathological complete response rate was 4.4 % (TRG1 according to Mandard); for the primary tumor, in most cases was TRG 3 – 87 %.Conclusion. Combined treatment modality, including NAC with FOLFOXIRI regimen and targeted therapy for CRC with liver metastases, is well tolerated, has a signifcant damaging effect on the tumor, and does not affect the course of the postoperative period. Further studies are required to assess the long-term treatment outcomes.https://www.siboncoj.ru/jour/article/view/2367colorectal cancerliver metastasesneoadjuvant chemotherapysurgery |
| spellingShingle | A. Yu. Dobrodeev D. N. Kostromitsky A. S. Tarasova S. G. Afanasyev N. N. Babyshkina A. A. Ponomaryeva R. V. Ermolenko I. G. Frolova O. V. Cheremisina Short-term outcomes of neoadjuvant chemotherapy in colorectal cancer patients with isolated liver metastasis Сибирский онкологический журнал colorectal cancer liver metastases neoadjuvant chemotherapy surgery |
| title | Short-term outcomes of neoadjuvant chemotherapy in colorectal cancer patients with isolated liver metastasis |
| title_full | Short-term outcomes of neoadjuvant chemotherapy in colorectal cancer patients with isolated liver metastasis |
| title_fullStr | Short-term outcomes of neoadjuvant chemotherapy in colorectal cancer patients with isolated liver metastasis |
| title_full_unstemmed | Short-term outcomes of neoadjuvant chemotherapy in colorectal cancer patients with isolated liver metastasis |
| title_short | Short-term outcomes of neoadjuvant chemotherapy in colorectal cancer patients with isolated liver metastasis |
| title_sort | short term outcomes of neoadjuvant chemotherapy in colorectal cancer patients with isolated liver metastasis |
| topic | colorectal cancer liver metastases neoadjuvant chemotherapy surgery |
| url | https://www.siboncoj.ru/jour/article/view/2367 |
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