Outcome of patients with metastatic colorectal cancer depends on the primary tumor site (midgut vs. hindgut): analysis of the FIRE1-trial (FuFIRI or mIROX as first-line treatment)
Outcome of patients with metastatic colorectal cancer depends on the primary tumor site (midgut vs. hindgut): analysis of the FIRE1-trial (FuFIRI or mIROX as first-line treatment)
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DOI：
10.1097/cad.0000000000000041
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发表时间：
2014-02-01
影响因子：
2.3
通讯作者：
Heinemann, Volker
中科院分区：
文献类型：
--
作者：
Modest, Dominik P.;Schulz, Christoph;Heinemann, Volker
本研究的目的是研究转移性结直肠癌(MCRC)患者接受FuFIRI或mIROX化疗时，中肠和后肠作为原发肿瘤部位的影响。我们分析了来自III期试验的423名患者，该试验以1：1的方式将患者随机分为FuFIRI或mIROX。队列分为中肠(n=82)和后肠(n=341)原发肿瘤。原发肿瘤部位(中肠与后肠)与治疗效果和生存期相关。我们的队列包括82名表现为原发性中肠肿瘤的患者和341名患有原发性后肠肿瘤的患者。中肠起源的肿瘤与后肠起源的肿瘤相比，预后较差。客观有效率分别为37%和43%(P=0.34)，中位无进展生存期分别为6.0月和8.2月(P=0.024，风险比：0.75)，中位总生存期分别为13.6月和21.8月(P=0.001，风险比：0.65)。中肠多发性结直肠癌的患者在两个研究组中都显示出明显的预后不良的趋势。然而，这种效应在mIROX组中似乎不那么明显。需要来自不同方案的大型试验的进一步数据集作为确认。(C)2014沃尔特斯·克鲁沃健康垂直酒吧Lippincott Williams&Wilkins。
The aim of this study was to investigate the impact of midgut versus hindgut as the primary tumor site in patients with metastatic colorectal cancer (mCRC) receiving chemotherapy with FuFIRI or mIROX. We analyzed 423 patients from a phase III trial that randomized patients in a 1 : 1 fashion to either FuFIRI or mIROX. The cohort was grouped into midgut (n=82) and hindgut (n=341) primary tumors. The primary tumor site (midgut vs. hindgut) was correlated with parameters of treatment efficacy and survival. Our cohort comprised 82 patients presenting with primary midgut tumors and 341 with primary hindgut tumors. Tumors of midgut origin compared with hindgut origin were associated with inferior outcome. Objective response rate was 37 versus 43% (P=0.34), median progression-free survival was 6.0 versus 8.2 months (P=0.024, hazard ratio: 0.75), and median overall survival was 13.6 versus 21.8 months (P=0.001, hazard ratio: 0.65). Patients with midgut mCRC showed a clear trend toward inferior outcome in both study arms. However, the effect appeared less pronounced in the mIROX arm. Further datasets from large trials with various regimens are required as confirmation. (C) 2014 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.