[Neoadjuvant chemotherapy for advanced colorectal cancer]

The prognosis of advanced colorectal cancer after surgical resection remains poor if curative resection cannot be achieved. Neoadjuvant chemotherapy( NAC) may increase the curative resection rate and reduce the recurrence rate following resection of marginally resectable advanced colorectal cancer by ensuring adequate surgical margin and controlling micro-metastases. Herein, we report the treatment regimen and outcomes of NAC for advanced colorectal cancer at our institute.

Between April 2005 and December 2012, 10 patients with marginally resectable advanced colorectal cancer received NAC before undergoing laparotomy. NAC consisted of 4 to 8 courses of the FOLFIRI-3 regimen combined with molecular targeted agents. Laparotomy was performed 4 to 6 weeks after the last course of NAC, and 12 courses of mFOLFOX6 were recommended as adjuvant chemotherapy after surgery.

A partial response (PR) according to Response Evaluation Criteria in Solid Tumors ver. 3 was observed in 5 patients and progressive disease (PD) was not observed in any patient. Curative resection was achieved in 9 patients. All patients are currently alive, and the 2-year relapse-free survival rate was 62.2%.

This is a retrospective study of a small number of subjects; however, the results suggest that NAC for marginally resectable advanced colorectal cancer increases the curative resection rate and reduces the recurrence rate.