Clinical Analysis Of Advanced Colorectal Cancer With Different Metastases Treated With First-line Oxaliplatin-based Regimens

Objective: To evaluate the difference of response rate (RR), toxicity, time to progression (TTP) and median survival time (MST) in advanced colorectal cancer patients with only liver or lymph node or synchronic liver and lymph node metastases treated with first-line oxaliplatin-based regimens.Method: Retrospective review is conducted on 164 patients with only liver or lymph node or synchronic liver and lymph node metastatic colorectal cancer with first-line oxaliplatin-based regimens from August 1999 to August 2008.The statistical analysis is performed with SPSS16.0.Results: For patients with only liver or lymph node or synchronic liver and lymph node metastases, the object RR was 42.9%, 37.3% and 30.8%, respectively.The disease control rate (DCR) was 78.6%,90.2% and 69.2%, respectively, and DCR of patients with only lymph node metastases was significantly superior to those with synchronic metastases (p=0.012). With median follow-up 21.63 months, median TTP was 9.07 months,10.03 months and 9.33 months, respectively. MST was 25.13 months,23.47 months and 20.43 months, respectively.2-year survival rate was 44.4%,34.0% and 20.5%, respectively, and that of patients with only liver metastases was significantly superior to those with synchronic metastases (p=0.012). 3-year survival rate was 12.5%, 17.0% and 2.6%, respectively, and that of patients with only lymph node metastases was significantly superior to those with synchronic metastases (p=0.028). In the patients of male, younger than 65 years old, PS 1, no adjuvant chemotherapy and response to oxaliplatin-based regimens, these patients with only lymph node metastases were significantly superior to those with synchronic metastases for TTP.In the patients whose primary site was colon, these patients with only liver metastases were significantly superior to those with synchronic metastases for MST.The most common side-effects were nausea/vomiting, nurotoxicity and hematological toxicities which all the difference were not statistically significant.Univariate analysis showed that patients who didn't respond to chemotherapy and had improved pretherapy CEA level had poorer TTP, and those with SD/PD,PS 2 and poorly differentiated tumor had poorer MST.By multivariate analysis, improved pretherapy CEA level (p=0.016) and PS 2 (p=0.014) was independent prognostic factors for TTP and MST, respectively.Conclusion: For advanced colorectal cancer with only liver or lymph node or synchronic liver and lymph node metastases, the differences of RR and TTP treated with oxaliplatin-based regimens were not significant, but the 2-year and 3-year survival rate of patients with synchronic liver and lymph node metastases were more poorer. We suggest that take a more positive subsequent therapy for those patients.