Transplant oncology: assessment of response and tolerance to systemic chemotherapy for metastatic colorectal cancer after liver transplantation - a retrospective study

Autor: Pål-Dag Line, Tormod Kyrre Guren, Svein Dueland, Tor Magnus Smedman
Rok vydání: 2019
Předmět:
Oncology
Adult
Graft Rejection
Male
medicine.medical_specialty
Colorectal cancer
medicine.medical_treatment
Population
Antineoplastic Agents
Kaplan-Meier Estimate
030230 surgery
Liver transplantation
Malignancy
Medical Oncology
03 medical and health sciences
0302 clinical medicine
Bone Marrow
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Mucositis
Immune Tolerance
Humans
Neoplasm Metastasis
education
Aged
Retrospective Studies
Transplantation
education.field_of_study
Chemotherapy
business.industry
Liver Neoplasms
Palliative Care
Retrospective cohort study
Middle Aged
medicine.disease
digestive system diseases
Liver Transplantation
Treatment Outcome
030211 gastroenterology & hepatology
Female
Neoplasm Recurrence
Local
business
Colorectal Neoplasms
Immunosuppressive Agents
ISSN: 0934-0874
Popis: Solid organ recipients have a 2-5 fold increased risk of malignancy compared to the general population. Because of the broader indications for transplantation, it is anticipated that an increasing number of organ graft recipients will present with malignancy. There are limited data about responses and tolerance to chemotherapy in solid organ transplanted patients. Twenty-three of 46 colorectal cancer (CRC) patients with nonresectable liver metastases who had undergone liver transplantation (LT) in three different studies were included. All patients had received chemotherapy both prior to LT and after LT, at recurrence of metastatic CRC (mCRC). Adverse reactions (grades 3-4) and clinical and radiological outcome were retrospectively registered. Overall survival was determined from start of palliative chemotherapy after LT. No graft rejection was observed. Chemotherapy for mCRC was overall well-tolerated and there was no increased bone marrow toxicity registered after LT; however, mucositis and diarrhea were more frequent in post-LT chemotherapy. Median overall survival from start of palliative chemotherapy after LT was 13 months. No graft loss was observed when chemotherapy for mCRC was given to LT recipients who had developed nonresectable metastases. Overall, the chemotherapy for mCRC was well-tolerated, induced responses, and long-term survival was obtained in some patients.
Databáze: OpenAIRE
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