51. Safety and efficacy of palliative systemic chemotherapy combined with colorectal self-expandable metallic stents in advanced colorectal cancer: A multicenter study
- Author
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Etienne Dorval, Driffa Moussata, Jean-Pierre Barbieux, Nicolas Ceze, Emmanuel Mitry, Thierry Lecomte, Thomas Aparicio, Christophe Locher, Antoine Charachon, and Bruno Landi
- Subjects
Oncology ,Adult ,Male ,medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,Perforation (oil well) ,Self Expandable Metallic Stents ,Antineoplastic Agents ,03 medical and health sciences ,0302 clinical medicine ,Self-expandable metallic stent ,Internal medicine ,medicine ,Humans ,Endoscopic stenting ,Aged ,Neoplasm Staging ,Retrospective Studies ,Aged, 80 and over ,Hepatology ,business.industry ,Palliative Care ,Gastroenterology ,Stent ,Combination chemotherapy ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Oxaliplatin ,Surgery ,Bowel obstruction ,Treatment Outcome ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Female ,business ,Colorectal Neoplasms ,medicine.drug - Abstract
Summary Purpose Self-expandable metallic stent (SEMS) placement is an accepted palliative therapy for management of acute malignant bowel obstruction in advanced colorectal cancer. Nevertheless, data are lacking on the effects of systemic chemotherapy combined with colorectal SEMS. The aim of this study was to investigate the safety and efficacy of palliative chemotherapy for advanced colorectal cancer combined with colorectal SEMS placement. Patients and methods This multicentre retrospective study included all consecutive advanced colorectal cancer patients who received first-line palliative chemotherapy combined with endoscopic stenting for colorectal cancer with obstruction. We analyzed the number of cycles and the type of combination used. The primary endpoint was overall survival. Secondary endpoints included progression-free survival, response rate, grade 3–4 toxicity and the outcomes of SEMS for malignant colorectal obstruction. Results A total of 38 patients were included. Among them, 25 patients received oxaliplatin and 5-fluorouracil combination chemotherapy. Objective response and stabilization occurred in 38 and 24% of patients, respectively. The median overall survival and progression-free survival from the start of chemotherapy were 18 and 5 months, respectively. The objective response rate and overall disease control rate were 38 and 62%, respectively. Toxicity was generally acceptable. Major complications related to stenting included perforation (8%), stent migration (5%), and reobstruction secondary to tumor ingrowths (13%). Conclusions Chemotherapy combined with colonic stenting as a first-line treatment seems to be a valid option in advanced colorectal cancer patients with malignant colorectal obstruction.
- Published
- 2015