Chinese Clinical Oncology

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Clinical observation of cetuximab combined with FOLFOX 4 regimen as neoadjuvant therapy for colorectal cancer with liver metastases

ZHANG Bin, WANG Bingji, CHENG Yuan, LIU Xianzhong, CHEN Yingxia   

  1. Department of Oncology Surgery, PLA Cancer Center, 81 Hospital of PLA, Nanjing 210002, China
  • Received:2013-07-26 Revised:2013-07-27 Online:2013-09-30 Published:2013-09-30

Abstract: Objective To evaluate the efficacy and adverse reaction of cetuximab combined with FOLFOX 4 regimen as neoadjuvant therapy for colorectal cancer with liver metastases. Methods A total of 18 patients with liver metastases from colorectal cancer were treated with cetuximab combined with FOLFOX 4 regimen. Cetuximab 400mg/m2 was intravenously given at the first dose and maintenance at 250mg/m2 every week for a total of 6 weeks. FOLFOX 4 regimen was given as follows: oxaliplatin 85mg/m2 iv,d1;calcium folinate 200mg/m2 iv,d1,d2; fluorouracil 400mg/m2 bolus,d1,d2,and then 600mg/m2 civ for 22h,d1,d2,2 weeks was a cycle. The efficacy were evaluated after 3 cycles.
ResultsThe efficacy could be evaluated in eighteen patients,with PR in 15 cases,SD in 2 cases,and PD in 1 case. The response rate was 83.3% and the disease control rate was 944%. Eighteen patients received surgery, 14 of them underwent synchronous radical colorectal surgery and liver metastases resection, and 4 cases received stage operation. R0 resection of primary lesion was performed in 18 patients, while R0 resection of liver metastases was operated in 15 cases and R1 resection in 3 cases. The median overall survival was 30.4 months, and the median progressionfree survival was 21.2 months. The adverse reaction during the treatment included grade 3 skin toxicity, grade 1-2 delayed diarrhea and grade 1-2 neutropenia. Conclusion FOLFOX 4 regimen combined with cituximab neoadjuvant therapy for colorectal cancer with liver metastases is effective and well-tolarable,which can increase the resectabiliy rate and prolong patients'survival may provide a new treating strategy for colorectal cancer with liver metastases.

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