Clinical effect of radiofrequency ablation in combination with small doses of capecitabine regimen for colorectal cancer patients with liver metastases

Abstract

Objective To explore the clinical effect and safety of radiofrequency ablation (RFA) in combination with small doses of capecitabine for colorectal cancer patients with liver metastases. Methods Among forty-six patients with colorectal liver metastasis from January 2010 to July 2015, 25 cases received RFA in combination with capecitabine regimen (combined therapy group) and the other 21 cases only received capecitabine regimen (chemotherapy alone group) with daily dose of 1 500 mg/m2, bid, for 2 weeks, with 3 weeks for a cycle. The curative effect of chemotherapy and RFA were analyzed according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 or three-phase enhanced CT, respectively. The long-term survival was followed up, and the complications of RFA and the chemotherapy-induced adverse reactions were recorded. Results In the combined therapy group, there were 13 cases of complete response (CR), 5 partial response (PR), 4 stable disease (SD) and 3 cases of progressive disease (PD), with the response rate (RR) and disease control rate (DCR) of 72.0% and 88.0%. In the chemotherapy alone group, there were 0 case of CR, 6 PR, 7 SD and 8 PD, with RR and DCR of 28.5% and 61.9%. There was higher DCR and RR in the combined treatment group compared with the chemotherapy alone group with a significant difference (χ2=8.627、4.272, P=0.003、0.038) . The curative effect of patients with one lesion was better than those with 2-5; and less than 3 cm in diameter was better than that of 3 to 6 cm; the survival rates of 1-, 2-, 3-year were 72.0% (18/25), 52.0% (13/25) and 21.4% (7/25) in the combined treatment group, higher than 47.6% (10/21), 19.0% (4/21) and 4.7% (1/21) of the chemotherapy alone group, respectively (P<0.05). The main complications of RFA were fever and local pain. There were similar adverse reactions in both groups, mainly including bone marrow suppression and gastrointestinal reaction, and the difference had no statistical significance. Conclusion RFA in combination with small dose of capecitabine chemotherapy treatment of colorectal liver metastasis can effectively control the tumor and prolong patients' survival. Key words: Intestinal neoplasms; Neoplasm metastasis; Ablation techniques; Capecitabine