BACKGROUND: Suitable chemotherapy is needed to prolong the survival of patients with unresectable advanced or recurrent colorectal cancer. We scored the periodical changes of several prognostic markers during chemotherapy in patients with this type of cancer to discern the effectiveness of chemotherapy. METHODS: Twenty consecutive patients with unresectable advanced or recurrent colorectal cancer were enrolled. All patients underwent combination chemotherapy with oxaliplatin or irinotecan plus 5-fluorouracil/leucovorin. Neutrophil/lymphocyte ratio (NLR), serum C-reactive protein (CRP), serum carcinoembryonic antigen (CEA) and serum albumin (ALB) were compared between the two periods (before chemotherapy and 3 months after it was started) in each patient. The scoring system was as follows: points are added when a patient shows a decrease of NLR, CRP and CEA and an increase of ALB at 3 months after the start of chemotherapy with a possible final score of +4. On the other hand, points are reduced if a patient shows an elevation of NLR, CRP and CEA and a decrease of ALB at 3 months after the start of chemotherapy with a possible final score of -4. RESULTS: At 3 months after the start of first line chemotherapy, 13 patients showed positive scores but 7 patients showed zero or minus scores. According to our scoring system, we found the mean survival time (MST) of the 13 patients with plus scores was 34 months and this was significantly better than that of the 7 patients who showed zero or minus scores (P = 0.0008). CONCLUSION: Our new scoring system is useful but when we find that first line chemotherapy is ineffective, we need to change it to second line chemotherapy as soon as possible. That may be the best treatment for patients with unresectable advanced or recurrent colorectal cancer.
BACKGROUND: Suitable chemotherapy is needed to prolong the survival of patients with unresectable advanced or recurrent colorectal cancer. We scored the periodical changes of several prognostic markers during chemotherapy in patients with this type of cancer to discern the effectiveness of chemotherapy. METHODS: Twenty consecutive patients with unresectable advanced or recurrent colorectal cancer were enrolled. All patients underwent combination chemotherapy with oxaliplatin or irinotecan plus 5-fluorouracil/leucovorin. Neutrophil/lymphocyte ratio (NLR), serum C-reactive protein (CRP), serum carcinoembryonic antigen (CEA) and serum albumin (ALB) were compared between the two periods (before chemotherapy and 3 months after it was started) in each patient. The scoring system was as follows: points are added when a patient shows a decrease of NLR, CRP and CEA and an increase of ALB at 3 months after the start of chemotherapy with a possible final score of +4. On the other hand, points are reduced if a patient shows an elevation of NLR, CRP and CEA and a decrease of ALB at 3 months after the start of chemotherapy with a possible final score of -4. RESULTS: At 3 months after the start of first line chemotherapy, 13 patients showed positive scores but 7 patients showed zero or minus scores. According to our scoring system, we found the mean survival time (MST) of the 13 patients with plus scores was 34 months and this was significantly better than that of the 7 patients who showed zero or minus scores (P = 0.0008). CONCLUSION: Our new scoring system is useful but when we find that first line chemotherapy is ineffective, we need to change it to second line chemotherapy as soon as possible. That may be the best treatment for patients with unresectable advanced or recurrent colorectal cancer.
Authors: Sarah Brophy; Katherine M Sheehan; Deborah A McNamara; Joseph Deasy; David J Bouchier-Hayes; Elaine W Kay Journal: Int J Cancer Date: 2009-12-15 Impact factor: 7.396
Authors: A de Gramont; J F Bosset; C Milan; P Rougier; O Bouché; P L Etienne; F Morvan; C Louvet; T Guillot; E François; L Bedenne Journal: J Clin Oncol Date: 1997-02 Impact factor: 44.544
Authors: Niels Halama; Sara Michel; Matthias Kloor; Inka Zoernig; Axel Benner; Anna Spille; Thora Pommerencke; Doeberitz Magnus von Knebel; Gunnar Folprecht; Birgit Luber; Nadine Feyen; Uwe M Martens; Philipp Beckhove; Sacha Gnjatic; Peter Schirmacher; Esther Herpel; Juergen Weitz; Niels Grabe; Dirk Jaeger Journal: Cancer Res Date: 2011-08-16 Impact factor: 12.701
Authors: P Lissoni; L Fumagalli; F Brivio; F Rovelli; G Messina; G Di Fede; M Colciago; G Brera Journal: J Biol Regul Homeost Agents Date: 2006 Jan-Jun Impact factor: 1.711