Influence of time schedule of radiofrequency ablation on the safety and prognosis of patients with colorectal cancer liver metastasis receiving XELOX regimen: A single-center clinical study

Objective To investigate the influence of time schedule of radiofrequency ablation (RFA) on the safety and prognosis of patients with colorectal cancer liver metastasis treated with RFA combined with XELOX regimen. Methods A retrospective analysis was performed for the clinical data of 48 patients with colorectal cancer liver metastasis who received RFA combined with XELOX regimen in Beijing Ditan Hospital from January 2011 to August 2017, and according to the time schedule of RFA, these patients were divided into group A (25 patients treated with RFA and sequential systemic chemotherapy ± targeted therapy) and group B (23 patients treated with chemotherapy ±targeted therapy and then RFA) . The patients with a stable disease or partial remission continued to take Xeloda orally until disease progression or intolerable side effects. The primary endpoint was objective response rate (ORR) of tumor, and the secondary endpoints included time to progression (TTP) , overall survival (OS) , and safety. Results There was no significant difference in ORR between group A and group B [68. 0% (8 patients with complete response and 9 with partial response) vs 43. 5% (2 patients with complete response and 9 with partial response) , χ2= 2. 927, P = 0. 087]. There were no significant differences between group A and group B in median TTP (9. 0 months vs 8. 0 months, χ2= 2. 660, P > 0. 05) and median OS (33 months vs 30 months, χ2= 0. 562, P > 0. 05) . For the patients with liver metastasis alone, there was a significant difference in median TTP between group A and group B (15. 0 months vs 8. 0 months, χ2= 4. 331, P = 0. 037) . Both groups had similar incidence and degree of common adverse events (AEs) (all P > 0. 05) . Most treatment-related AEs were mild or moderate; the most common mild AE (grade I/II) was leucopenia (93. 8%) , followed by nausea (91. 7%) and abdominal pain (81. 3%) . There were no fatal AEs, and the most common grade III/IV treatment-related AE was hematological toxicity observed in14 patients (29. 2%) . All AEs were resolved without sequelae. Conclusion RFA combined with XELOX-Xeloda maintenance chemotherapy is well tolerated and has a good clinical effect in patients with colorectal cancer liver metastasis. For patients with liver metastasis alone, RFA followed by chemotherapy can improve ORR of tumor.