A Phase II Study of Modified FOLFOX4 for Colorectal Cancer Patients with Peritoneal Carcinomatosis
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Purpose Peritoneal carcinomatosis (PC) of colorectal cancer (CRC) is common and is the second most common cause of death. Clinical studies regarding chemotherapy for CRC with PC have been classically rather limited in scope. We evaluated the efficacy of modified oxaliplatin, leucovorin,and fluorouracil (m-FOLFOX4) regimen for PC of CRC origin. Materials and Methods CRC patients with PC were treated with cycles of oxaliplatin at 85 mg/m^2 on day 1, leucovorin 20mg/m^2 followed by 5-fluorouracil (5-FU) via a 400 mg/m^2 bolus and a 22 hours continuous infusion of 600 mg/m^2 5-FU on days 1-2 at 2-week intervals. Results Forty patients participated in this study. Median age was 55 years. Thirty-two patients (80.0%) received previous operation, and 60.0% of PC occurred synchronously. Thirty-five patients (87.5%)were assessable and exhibited measurable lesions. Two patients (5.7%) demonstrated complete response and five patients (14.3%) showed partial response. The median time to progression was 4.4 months (95% confidence interval, 2.5 to 6.3 months), the median overall survival time was 21.5months (95% confidence interval, 17.2 to 25.7 months). There was no treatment related death. Presence of liver metastasis (p=0.022), performance status (p=0.039), and carcinoembryonic antigen level (p=0.016) were related to the time to progression. Patients with low carcinoembryonic antigen level (37.2 months vs. 15.6 months, p=0.001) or good performance status (22.5 months vs. 6.8 months, p=0.040) showed better overall survival. Conclusion The m-FOLFOX4 regimen was determined to be effective for CRC patients with PC.
Abstract
Purpose Peritoneal carcinomatosis (PC) of colorectal cancer (CRC) is common and is the second most common cause of death. Clinical studies regarding chemotherapy for CRC with PC have been classically rather limited in scope. We evaluated the efficacy of modified oxaliplatin, leucovorin,and fluorouracil (m-FOLFOX4) regimen for PC of CRC origin. Materials and Methods CRC patients with PC were treated with cycles of oxaliplatin at 85 mg/m^2 on day 1, leucovorin 20mg/m^2 followed by 5-fluorouracil (5-FU) via a 400 mg/m^2 bolus and a 22 hours continuous infusion of 600 mg/m^2 5-FU on days 1-2 at 2-week intervals. Results Forty patients participated in this study. Median age was 55 years. Thirty-two patients (80.0%) received previous operation, and 60.0% of PC occurred synchronously. Thirty-five patients (87.5%)were assessable and exhibited measurable lesions. Two patients (5.7%) demonstrated complete response and five patients (14.3%) showed partial response. The median time to progression was 4.4 months (95% confidence interval, 2.5 to 6.3 months), the median overall survival time was 21.5months (95% confidence interval, 17.2 to 25.7 months). There was no treatment related death. Presence of liver metastasis (p=0.022), performance status (p=0.039), and carcinoembryonic antigen level (p=0.016) were related to the time to progression. Patients with low carcinoembryonic antigen level (37.2 months vs. 15.6 months, p=0.001) or good performance status (22.5 months vs. 6.8 months, p=0.040) showed better overall survival. Conclusion The m-FOLFOX4 regimen was determined to be effective for CRC patients with PC.
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