Value Of Neoadjuvant Chemotherapy In Treatment Of Colorectal Cancer Liver Metastases

Objective: To discuss the value of neoadjuvant chemotherapy in treatmentof colorectal cancer liver metastases.Method: Seventy-eight cases of colorectal cancer liver metastases wereretrospectively analyzed(according to inclusion and exclusion criteria). Allpatients underwent neoadjuvant chemotherapy before surgery in Tumor Hospitalof Guangxi Medical University from January2010to June2013. We comparedthe size of primary colorectal cancer and its liver metastases and serum CEAlevel before and after neoadjuvant chemotherapy. And we analyzed radicalresection rate, chemotherapy side effects, surgical complications andpostoperative follow-up of these patients.Results: Assessment of efficacy based on the changes in liver metastasesbefore and after neoadjuvant chemotherapy, the objective response rate for allpatients was66.67%(52/78), with0cases of complete remission (CR),52partial remission (PR),15stable disease (SD), and1progressive disease(PD).Assessment of efficacy based on changes in primary tumor before and afterneoadjuvant chemotherapy, the objective response rate for all patients was57.69%(45/78), with0cases of complete remission (CR),45partial remission (PR),31stable disease (SD), and2progressive disease(PD). After receivingneoadjuvant chemotherapy, the size of primary tumor and its liver metastasesdecreased significantly in most patients, and so did the serum CEA levels. Thesedifferences before and after neoadjuvant chemotherapy was statisticallysignificant(P＜0.05). The radical resection rate of patients underwentneoadjuvant chemotherapy was29.48%(23/78). The recurrence of colorectalliver metastases within6months after radical resection occurred in17.39%(4/23)of patients. Patients who received neoadjuvant chemotherapy did not appearserious adverse reactions to chemotherapy, and surgical complication rate wasno significant increase.Conclusion:1.Neoadjuvant chemotherapy shows good therapeutic effect on colorectal livermetastases, and can improve patient’s curative resection rate.2.Neoadjuvant chemotherapy is a safe means for treating patients withcolorectal liver metastases.3.Patients with colorectal liver metastases who obtained radical surgery afterneoadjuvant chemotherapy need to be closely observed postoperatively andpostoperative intervention of patient should be emphasized.