Brief Article
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World J Gastrointest Oncol. Apr 15, 2011; 3(4): 60-66
Published online Apr 15, 2011. doi: 10.4251/wjgo.v3.i4.60
Chemotherapy plus percutaneous radiofrequency ablation in patients with inoperable colorectal liver metastases
Joseph Sgouros, James Cast, Krishna K Garadi, Maria Belechri, David J Breen, John RT Monson, Anthony Maraveyas
Joseph Sgouros, Krishna K Garadi, Maria Belechri, Anthony Maraveyas, Academic Department of Oncology, Castle Hill Hospital, Cottingham, HU16 5JQ, United Kingdom
Joseph Sgouros, “Agii Anargiri” Cancer Hospital, N Kifissia, 14564, Greece
James Cast, David J Breen, Radiology Department, Castle Hill Hospital, Cottingham, HU16 5JQ, United Kingdom
John RT Monson, Division of Colorectal Surgery, Department of Surgery University of Rochester Medical Center, 601 Elmwood Avenue, Box SURG, Rochester, NY 14642, United States
Author contributions: Cast J, Breen DJ, Monson JRT and Maraveyas A designed the studies; Sgouros J, Cast J, Garadi KK, Belechri M, Breen DJ, Monson JRT and Maraveyas A performed the research; Sgouros J and Maraveyas A wrote the paper; Cast J, Garadi KK, Belechri M, Breen DJ and Monson JRT reviewed the paper.
Correspondence to: Joseph Sgouros, MD, “Agii Anargiri” Cancer Hospital, N Kifissia, 14564, Greece. josephsgouros@yahoo.co.uk
Telephone: +30-694-7961576 Fax: +30-210-8003946
Received: August 15, 2010
Revised: February 10, 2011
Accepted: February 17, 2011
Published online: April 15, 2011
Abstract

AIM: To access the efficacy of chemotherapy plus radiofrequency ablation (RFA) as one line of treatment in inoperable colorectal liver metastases.

METHODS: Eligible patients were included in three Phase II studies. In the first study percutaneous RFA was used first followed by 6 cycles of 5-fluorouracil, leucovorin and irinotecan combination (FOLFIRI) (adjunctive chemotherapy trial). In the other two, chemotherapy (FOLFIRI or 5-fluorouracil, leucovorin and oxaliplatin combination) up to 12 cycles was used first with percutaneous RFA offered to responding patients (primary chemotherapy trials).

RESULTS: Thirteen patients were included in the adjunctive chemotherapy trial and 17 in the other two. At inclusion they had 1-4 liver metastases (up to 6.5 cm in size). Two patients died during chemotherapy. All patients in the adjunctive chemotherapy trial and 44% in the primary chemotherapy studies had their metastases ablated. Median PFS and overall survival in the adjunctive study were 13 and 24 mo respectively while in the primary chemotherapy studies they were 10 and 21 mo respectively. Eighty one percent of the patients had tumour relapse in at least one previously ablated lesion.

CONCLUSION: Chemotherapy plus RFA in patients with low volume inoperable colorectal liver metastases seems safe and relatively effective. The high local recurrence rate is of concern.

Keywords: Chemotherapy; Colorectal cancer; Liver metastases; Radiofrequency ablation