Study of the effectiveness of chemotherapy in patients with colorectal cancer depending on the location of the metastatic lesion.

Abstract

e15540 Background: The reason for the increased interest in the chemotherapeutic treatment of metastatic colorectal cancer (CRC) is the steady increase in the incidence of this oncological pathology, as well as the high incidence of neglect of the tumor process in a significant proportion of patients in the absence of improvement in long-term treatment results. Methods: In 84 patients with metastatic CRC (mCRC), the clinical effect and toxicity of the FOLFOX4 and CAPOX regimens were studied. In 51 (60.7%) patients, multiple metastases in various organs were most common, in 18 (21.4%) - solitary, and only in 15 (17.9%) patients - solitary. Among the examined patients, men accounted for 46 (54.7%), women - 38 (45.2%). The average age of men was 57.2+0.2 years, women 65.4+0.4 years. Patients underwent 2-4 courses of treatment, after which the effect of PCT was evaluated according to the REGIST scale (2009). Results: Out of 84 patients with mCRC who received 2-4 courses of palliative chemotherapy according to the FOLFOX4 and CAPOX regimens, complete regression of the process was observed in 14 (16.7%) patients, partial regression in 34 (40.5%) patients, stabilization of the process in 19 (22.6%) and in 17 (20.2%) progression of the disease was revealed. At the same time, the highest objective response rate (PR + FR) was with metastases in the liver - 16 (76.1%) and lungs - 12 (63.1%). Of the 3 patients with brain metastases, stabilization was noted in 2 cases and progression of the process in 1 case. With combined distant metastases (lungs + liver and lungs + bones), there were 2-3 times more patients who were not sensitive to therapy than those who were sensitive. With combined distant metastases (lungs + liver and lungs + bones), there were 2-3 times more patients who did not respond to therapy than those who were sensitive to treatment. The “treatment sensitive” group included 48 (57.1%) patients with complete and partial regression. The “treatment-resistant” group consisted of 36 (42.9%) patients with progression and stabilization of the disease. Conclusions: The highest objective response rate (PR+FR) in patients with mCRC was with metastases in the liver - 16 (76.1%) and lungs - 12 (63.1%). The comparatively better results in metastatic lesions of the liver and lungs are obviously associated with a more developed blood supply to these organs, which leads to a better supply of chemotherapy drugs and the effectiveness of treatment. At the same time, the combination of localization of CRC metastatic lesions in various organs significantly worsens the results of treatment.