Impact of dose intensity of first-line chemotherapy on prognosis of patients with metastatic colorectal cancer / 肿瘤

ABSTRACT

Objective: To explore the impact of dose intensity of first-line chemotherapy on disease control rate (DCR) and overall survival (OS) of patients with metastatic colorectal cancer (mCRC). Methods: The clinical data of 37 patients with mCRC from March 2012 to December 2015 were retrospectively analyzed. All of the patients received FOLFOX regimen as first-line chemotherapy in Tianjin Medical University Cancer Institute and Hospital. The values of 80%, 75% and 85% were respectively used as the cutoff points of relative dose intensity (RDI) of oxaliplatin, 5-fluorouracil and the average RDI (ARDI). Kaplan-Meier method and log-rank test were used for univariate survival analysis and the COX proportional hazard regression model was used for multivariate survival analysis. Results: The DCRs of oxaliplatin RDI ≥80% group, 5-fluorouracil RDI ≥75% group and ARDI ≥ 85% group were respectively higher than those of oxaliplatin RDI 0.05). Kaplan-Meier univariate survival analysis showed that age, subsequent surgery, subsequent chemotherapy, first-line oxaliplatin RDI, first-line 5-fluorouracil RDI and serum carbohydrate antigen (CA) 19-9 level before chemotherapy had effects on OS of patients with mCRC (all P 0.05). COX multivariate analysis showed that subsequent surgery, subsequent chemotherapy and first-line oxaliplatin RDI were independent prognostic factors for OS (all P < 0.05) of mCRC patients. Conclusion: First-line oxaliplatin RDI is an independent prognostic factor for patients with mCRC. Patients who received first-line oxaliplatin RDI≥80% have better OS than those who received first-line oxaliplatin RDI < 80%. These findings throw light on the standardized chemotherapy for advanced colorectal cancer patients.