ROLE OF PERIOPERATIVE CHEMOTHERAPY IN COMBINED TREATMENT OF METASTATIC COLORECTAL CANCER WITH ISOLATED LUNG OR LIVER METASTASES

Purpose. Treatment tactics for metastatic colorectal cancer changed towards a more aggressive approach using rational combination of all available treatment methods. Perioperative treatment becomes more widespread for patients with isolated lung or liver metastases.

Methods. Preliminary analysis of combined treatment of 36 metastatic colorectal cancer patients, age 38–76, who received perioperative treatment in medical oncology department since 2005 is presented. All patients received 3 months of chemotherapy as initial treatment with oxaliplatin/irinoteca-based regimens +/- targeted therapy. RECIST criteria were used for response estimation. Following treatment employed surgery ot radiofrequency ablation of metastatic disease. Postoperative chemotherapy (6 cycles) was carried out using the same regimens.

Results. 4–8 cycles of chemotherapy were carried out preoperatively, which allowed to carry out surgery in 35 patients after 3–7.5 weeks. Objective response or disease stabilization was observed in 34 patients, 2 patients had progressive disease. Median followup was 35 months. 10 patients experienced disease progression during 1–6 months after treatment. Median time to progression among these 10 patients was 4 months. 5 patients died of disease progression after 35–48 months.

Conclusions. Perioperative chemotherapy represents a rational treatment strategy, improving treatment results, survival, time to progression in metastatic colorectal cancer patients. Further research is warranted to confirm results of pilot studies.

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