Abstract | PURPOSE: To evaluate clinical characteristics and survival outcomes among patients with locally advanced or metastatic colorectal cancer who achieve a complete response (CR) to systemic treatment either alone or with multimodality approach. PATIENTS AND METHODS: RESULTS: Sixty-two (4%) of 1,508 patients had a CR to chemotherapy alone, and an additional 32 (2%) had a CR after multimodality treatment. Factors associated with achieving CR with systemic chemotherapy alone included FOLFOX4 treatment, patients with assessable disease, or a single site of metastasis. Continuing protocol treatment beyond two cycles after documentation of CR was not associated with improved survival. The rate of curative intent resection was significantly higher for patients treated with oxaliplatin-containing regimens (P = .02). Median survival was similar between patients with CR after chemotherapy alone (44.3 months) or after multimodality approach (47.4 months; P = .81). CONCLUSION: FOLFOX4 was more likely to produce a CR than were IFL or IROX. Oxaliplatin regimens were more likely to result in successful surgical resections. Patients who have CR to systemic chemotherapy alone can achieve impressive survival outcomes similar to those seen among patients who attained a CR status after multimodality treatment.
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Authors | Grace K Dy, James E Krook, Erin M Green, Daniel J Sargent, Thierry Delaunoit, Roscoe F Morton, Charles S Fuchs, Ramesh K Ramanathan, Stephen K Williamson, Brian P Findlay, Barbara A Pockaj, Robert P Sticca, Steven R Alberts, Henry C Pitot 4th, Richard M Goldberg, Intergroup N9741 |
Journal | Journal of clinical oncology : official journal of the American Society of Clinical Oncology
(J Clin Oncol)
Vol. 25
Issue 23
Pg. 3469-74
(Aug 10 2007)
ISSN: 1527-7755 [Electronic] United States |
PMID | 17687151
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
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Chemical References |
- Antineoplastic Agents
- Organoplatinum Compounds
- Oxaliplatin
- Irinotecan
- Leucovorin
- Fluorouracil
- Camptothecin
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Topics |
- Aged
- Antineoplastic Agents
(therapeutic use)
- Camptothecin
(analogs & derivatives, therapeutic use)
- Colorectal Neoplasms
(drug therapy, mortality)
- Combined Modality Therapy
(methods)
- Female
- Fluorouracil
(therapeutic use)
- Follow-Up Studies
- Humans
- Irinotecan
- Leucovorin
(therapeutic use)
- Male
- Middle Aged
- Neoplasm Metastasis
- Organoplatinum Compounds
(therapeutic use)
- Oxaliplatin
- Remission Induction
- Retrospective Studies
- Treatment Outcome
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