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PURPOSE: ATP-based chemotherapy response assay (ATP-CRA) is a well-documented and validated technology that can individualize chemotherapy. This study was undertaken to assess the usefulness of ATP-CRA in advanced colorectal cancer (CRC) patients receiving adjuvant chemotherapy. METHODS: A total of 136 patients with curative resection between January 2006 and April 2014 were evaluated using ATP-CRA. Patients received either the FOLFOX or Mayo clinic regimen chemotherapy following assay results. The sensitive-group (S-group) was defined as a drug-producing ≥ 40% reduction in ATP, and the resistant-group (R-group) as an ATP reduction of < 40%. These 2 groups were further subdivided to produce 4 subgroups: the FOLFOX sensitive subgroup (the FS subgroup [n = 65]), the Mayo sensitive subgroup (the MS subgroup [n = 40]), the FOLFOX resistant subgroup (the FR subgroup [n = 10]), and the Mayo resistant subgroup (the MR subgroup [n = 21]). Clinical responses and survival results were compared for both treatment regimens. RESULTS: The FS and MS subgroups showed a better disease-free survival rate (29% vs. 40%, 35% vs. 47.6%) and overall survival rate (92.3% vs. 80.0%, 87.5% vs. 76.2%) than FR and MR subgroups. The FS and MS subgroups showed a longer time to relapse (20.2 months vs. 9.5 months, 17.6 months vs. 16.4 months) than the FR and MR subgroups. CONCLUSION: ATP-CRA tailored-chemotherapy has the potential to provide a survival benefit in resectable advanced CRC.
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Humans , Adenosine Triphosphate , Adenosine , Chemotherapy, Adjuvant , Colorectal Neoplasms , Disease-Free Survival , Drug Screening Assays, Antitumor , Drug Therapy , Recurrence , Survival RateABSTRACT
Objective To study the clinical effect of Kangaiping Wan on postoperative patients with colorectal cancer treated by FOLFOX chemotherapy.Methods 78 cases of colorectal cancer patients admitted from February 2014 to January 2015 in our hospital were selected and divided into observation group and control group according, 39 cases in each group.The control group was treated with FOLFOX4 regimen, and the patients in the observation group were treated with Kangaiping Wan on the basis of the control group.Two groups of patients before and after treatment of immune function improvement were compared, two groups of patients with clinical efficacy, quality of life to improve the situation, adverse reactions were compared.Results After treatment, the total effective rate of the observation group was significantly higher than the control group, the difference was statistically significant (P<0.05), quality of life of the observation group was significantly higher than the control group, the difference was statistically significant (P <0.05); There were no significant differences in the rates of oral mucositis, thrombocytopenia, hemoglobin, leukocytopenia and peripheral neurotoxicity in the two groups.The diarrhea and nausea and vomiting rate in the observation group were significantly lower than those in the control group (P<0.05).Conclusion FOLFOX regimen for patients with colorectal cancer after chemotherapy, combined with Kangaiping Wan, can effectively improve the clinical symptoms and quality of life of patients and enhance the immune function ,the clinical efficacy is good and the safety is high.
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Objective To investigate the effect of Avastin (bevacizumab) combined with preoperative FOLFOX neoadjuvant chemotherapy on the prognosis of patients with locally advanced rectal cancer (LARC).MethodsA total of 80 cases of patients with LARC treated with total mesorectal excision (TME) in our hospital from January 2013 to January 2016 were randomly divided into the control group and the observation group, 40 cases in each group.The control group were treated with preoperative FOLFOX chemotherapy while the observation group were treated with bevacizumab injection, based on the treatment in the control group.21 days was a cycle of chemotherapy, and both groups were treated for at least 4 cycles.After 6 cycles of chemotherapy, operation was carried out, following TEM principle.The short-term and long-term prognosis, rate of R0 resection, the incidence of postoperative complications and side effects of chemotherapy were compared between the two groups.ResultsThere was no significant difference between the two groups in the good response rate of chemotherapy, the rate of R0 resection, the incidence of postoperative complications, the 1-year and 3-year survival rates and 1-year disease-free survival rate.The incidence rates of gastrointestinal reactions and bone marrow suppression in the observation group were 52.5% and 52.5%, respectively while in the control group were 25.0% and 20.0%, respectively (P<0.05), but there was no significant difference in the incidence rates of grade Ⅲ~Ⅳ gastrointestinal reaction and bone marrow suppression between the observation group and the control group (5.0% and 15.0% vs 2.5% and 5.0%).The 3-year disease-free survival rate of the observation group was higher than that of the control group (82.5% vs 60.0%) (P<0.05).ConclusionThe application of bevacizumab combined with preoperative FOLFOX chemotherapy in the treatment of LARC can improve the 3-year disease-free survival rate, without increasing postoperative adverse reactions and serious side effects of chemotherapy.
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PURPOSE: Treatment options for patients with advanced gastric cancer remain limited. Few studies have investigated the efficacy and tolerability of the combination regimen of oxaliplatin and 5-fluorouracil with leucovorin for patients with advanced gastric cancer. The goal of this study was to examine the efficacy and toxicity of a modified FOLFOX-6 (mFOLFOX-6) regimen as a first-line chemotherapy regimen for patients with advanced gastric cancer. MATERIALS AND METHODS: From March, 2006, to December, 2007, 82 patients with advanced gastric cancer received 100 mg/m2 oxaliplatin and 100 mg/m2 leucovorin on the first day of treatment, followed by 2,400 mg/m2 of 5-fluorouracil on the first and second days of treatment every 2 weeks as a first-line treatment. RESULTS: The median age of the enrolled patients was 62 years (range; 30~75). Out of 82 patients, 34 cases (41.5%) were recurrent cases after curative resection, and the other 48 cases were unresectable or non-curative resectable cases. Their response was evaluated every 6 weeks. The overall response rate was 40.2%, with 2 (2.4%) complete response and 31 (37.8%) partial responses. The median time to progression (TTP) and overall survival (OS) time were 6.0 months (95% confidence interval [CI]: 4.69~7.31) and 13.0 months (7.99~18.0), respectively. The grade 3~4 hematologic toxicities observed included neutropenia (34.1%), thrombocytopenia (7.3%), and anemia (1.2%). The gastrointestinal toxicities observed included grade 3~4 nausea (9.8%) and vomiting (7.3%). Six patients (7.3%) experienced grade 3 neuropathy. No treatment-related deaths were recorded. CONCLUSION: The modified FOLFOX-6 regimen is effective and well tolerated as a first-line chemotherapy regimen for patients with advanced gastric cancer.