Neoadjuvant chemotherapy followed by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for colorectal cancer: a feasibility and safety studyLeimkühler, M., Hemmer, P., Reyners, A. K. L., de Groot, D., van Ginkel, R., Been, L., de Bock, G. H. & van Leeuwen, B., 11-Jan-2019, In : World journal of surgical oncology. 17, 1, 7 p., 14.
Research output: Contribution to journal › Article › Academic › peer-review
- Targeted Gynaecologic Oncology (TARGON)
- Guided Treatment in Optimal Selected Cancer Patients (GUTS)
- Life Course Epidemiology (LCE)
- Damage and Repair in Cancer Development and Cancer Treatment (DARE)
- Clinical Cognitive Neuropsychiatry Research Program (CCNP)
- Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE)
BACKGROUND: Standard treatment for colorectal peritoneal carcinomatosis typically involves cytoreductive surgery, hyperthermic intraperitoneal chemotherapy (HIPEC), and if possible, postoperative adjuvant chemotherapy. However, a substantial percentage of patients never receive adjuvant chemotherapy because of postoperative complications. Neoadjuvant chemotherapy could be beneficial in this setting, so we assessed its feasibility and safety when used before cytoreductive surgery and HIPEC.
METHODS: In this non-randomized, single-center, observational feasibility study, patients were scheduled to receive six cycles of capecitabine and oxaliplatin before cytoreductive surgery and HIPEC. Computed tomography was performed after the third and sixth chemotherapy cycles to evaluate tumor response, and patients underwent cytoreductive surgery and HIPEC if there were no pulmonary and/or hepatic metastases. Postoperative complications, graded according to the Clavien-Dindo classification, were compared with those of a historic control group that received postoperative adjuvant chemotherapy.
RESULTS: Of the 14 patients included in the study, 4 and 3 had to terminate neoadjuvant chemotherapy early because of toxicity and tumor progression, respectively. Cytoreductive surgery and HIPEC were performed in eight patients, and the timing and severity of complications were comparable to those of patients in the historic control group treated without neoadjuvant chemotherapy.
CONCLUSION: Patients with peritoneal metastases due to colorectal carcinoma can be treated safely with neoadjuvant chemotherapy before definitive therapy with cytoreductive surgery and HIPEC.
TRIAL REGISTRATION NUMBER: NTR 3905, registered on 20th march, 2013, http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=3905.
|Number of pages||7|
|Journal||World journal of surgical oncology|
|Publication status||Published - 11-Jan-2019|