Comparison of treatment efficacy between adjuvant intravenous chemotherapy and intravenous chemotherapy combined with intraperitoneal perfusion chemotherapy to treat postresection colon cancer

J Cancer Res Ther. 2018;14(7):1600-1605. doi: 10.4103/jcrt.JCRT_613_17.

Abstract

Background: Surgery has been the definitive treatment for locoregional colon cancer. But approximately 40% of patients died from peritoneal seeding and tumor recurrence. To prevent peritoneal recurrence, the eradication of intraperitoneal cancer cells has been critical for improving postoperative survival. This study focused on the role of IPC in postoperative treatment of colon cancer.

Patients and methods: Seventy colon cancer patients who underwent radical resection from September 2009 to September 2012 received adjuvant therapy. Specifically, 39 individuals received intravenous chemotherapy (IVC), and 31 received combined IVC and intraperitoneal perfusion chemotherapy (IVC + IPC). Disease-free survival (DFS) for those received IVC (20.71 months) was shorter than those received IVC + IPC (25.71 months). DFS in IVC group was also shorter than that in the IVC + IPC group, for patients with Stage III pathological tumor staging, T4 invasion depth, N2 lymph node metastasis, and low to undifferentiated tumor tissue. Peritoneal metastasis in the IVC + IPC group was less, but the toxicity was similar. No significant difference was observed among IPC treatment groups using three drugs. In the IVC + IPC group, DFS of patients received >5 or 3-5 times of IPC was longer than those received <3 times of treatment. No significant difference was observed in DFS between patients who received >5 times or 3-5 times of IPC.

Conclusion: After radical resection, patients who received IVC + IPC showed prolonged DFS than those received IVC, as well as fewer peritoneal metastasis. Compared to IPC, no significantly increased side effects or complications were occurred after IVC + IPC. More work should be performed to confirm that IVC + IPC was superior to IVC for treating postresection colon cancer.

Keywords: Clinical efficacy; colon cancer; intraperitoneal chemoperfusion; intravenous chemotherapy.

MeSH terms

  • Administration, Intravenous
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Chemotherapy, Adjuvant
  • Colonic Neoplasms / diagnosis
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / mortality
  • Colonic Neoplasms / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Infusions, Parenteral
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Staging
  • Postoperative Care*
  • Recurrence
  • Treatment Outcome