| Popis: |
Background Fluoropyrimidine (Fp) is one of the key drugs of chemotherapy in unresectable colorectal cancer (CRC), and usually used not only in first-line but also in second-line as beyond progression. The efficacy in combination of irinotecan, oxaliplatin and bevacizumab (BEV) with various types of Fp such as S-1, capecitabine and 5-FU were reportedly equivalent. However, clinical impacts of Fp switching between first- and second-line treatment are not well known. Here, we investigated the efficacy of Fp switching in sequential treatment of chemotherapy in unresectable CRC. Method We retrospectively reviewed the medical records of patients with unresectable CRC who had received doublet with BEV both in first- and second-line at our hospital between January 2012 and December 2016. Patients were divided into two groups: patients who received Fp switching and no switching through the sequential treatment. Results A total of 28 patients were analyzed. Seven patients received Fp switching and 21 patients received no switching: the median age was 43/65 years, male was 86/48%, performance status of 0 was 100/86%, RAS wild type was 57/43%, primary site of right side was 43/52% and more than 2 metastases was 43/62% respectively. Details of Fp switching were: changes from 5-FU to cape in one (14%), from cape to 5-FU in 4 (57%), from S-1 to cape in 2 (28%). The median progression-free survival of Fp switching and no switching was: 10.5 and 8.3 months (m) in first-line (p = 0.881), 5.1/4.8 m in second-line (p = 0.692), and 18.9/19.1 m in first + second-line (p = 0.537), respectively. Overall survival was 23.2/24.3 m (p = 0.537), respectively. Objective response rate was 67/55% (p = 0.404) in first-line, and 0/5% (p = 0.760) in second-line, respectively. Conclusions There were no significant differences in the efficacy of Fp switching in this study. |
