Aim To compare efficacy and toxicity of bolus application of chemotherapy protocol, oxaliplatin, fluorouracil (bolus), leucovorin (folfox) between two groups of patients in the therapy of metastatic colorectal carcinoma (mCRC). Methods A total of 63 patients were treated for mCRC in the period January 2009 – January 2010 at the Department of Oncology of the Cantonal Hospital Zenica, Bosnia and Herzegovina (first group, 30 patients) and at the Department of Oncology of the Clinical Hospital Centre Bežanijska kosa in Belgrade, Serbia, in the period January 2005 – January 2006 (second group, 33 patients). The patients were treated according the same protocol, i.v. bolus infusion, but in different day intervals (D), 1, 8, 15/28 days or D1-D5/28 days, respectively. In all patients the following factors were analyzed: tumor response, overall survival (OS), progression free survival, hematological and non-hematological toxicity . Results Colon was the primary localization in almost two thirds of patients. There was no statistically significant difference between the groups according to the age, hematological and non-hematological toxicity, as well as in achieved OS. Progression free survival expressed in months was in average 5 months though with a large range between minimal and maximal survival time. Conclusion Both groups have shown equivalent efficacy to applied chemotherapy protocols. Overall survival in the two groups matched data from the literature. Further research should confirm success of the combination of chemotherapy protocols and their combination with the biological therapy.
Benson A. Epidemiology, disease progression and economic burden of colorectum cancer. JMCP. 2007. p. 5–18.
2.
Boyle P, Levin B. World cancer report. Lyon: International Agency for Research on Cancer. 2008.
3.
Vrdoljak E, Wojtukeiwicz M, Pienkowski T, Bodoky G, Berzinec P, Finek J, et al. Cancer epidemiology in Central and South Eastern European countries. CMJ. 2011. p. 478–87.
4.
Fearlay J, Steliarova-Foucher E, Loret-Tieulent J, Rosso S, Coebergh J, Comber H, et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. EJC. 2013. p. 1374–403.
5.
Incidencija i mortalitet od raka u centralnoj Srbiji 2009. Beograd: Insititut za javno zdravlje. Jovan Jovanović Batut. 2011.
6.
Eduard V, Mirko Š, Zvonko K, Marija P, Damir P, Damir G, et al. Medicinska naklada. 2013.
7.
Ashan H, Neugut A, Garbovski G, Jacobson J, Forde K, Treat M, et al. Family history of colorectal adenomatous polyps and increased risk for colorectal cancer. Ann intern Med. 1998. p. 900–5.
8.
Fuchs C, Giovannucci E, Colditz G, Hunter D, Speizer F, Willett W. A prospective study of family history and the risk of colorectal cancer. N Engl J Med. 1994. p. 1669–74.
9.
Winawer S. Natural history of colorectal cancer. Am J Med. 1999. p. 3S-6S.
10.
Koretz R. Malignat polyp: are they sheep in wolves , clothing? Ann Intern Med. 1993. p. 63–8.
11.
Winawer S, Fletcher R, Rex D, Bond J, Burt R, Ferrucci J, et al. Colorectal cancer screening and surveillance: clinical guidelines and rationale-update based on now evidence. Gastroenterology. 2003. p. 544–60.
12.
U. Preventive Services Task Force. Screening for colorectal cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Inter Med. 2008. p. 627–37.
13.
Cochen A. Surgical consideration in patients with cancer of the colon and rectum. Semin Oncol. 1991. p. 381–419.
14.
Fazio V, Church J, Delaney C. Current Therapy Colon and Rectal Surgery. 2 nd ed. Elsevier Mosby; 2005. p. 379–88.
15.
Dobrila-Dintijana R, Bagić Ž, Štimac D. Kemoterapija kolorektalnog karcinoma. Medix. 2008. p. 119–25.
16.
Tournigand C, Andre T, Achille E, Liedo G, Flesh M, Mery-Mignard D, et al. FOLFIRI followed by FOLFOX6 or the reverse seguencein advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol. 2004. p. 229–37.
17.
Goldberg R, Morton R, Sargent D, Fuchs C, Ramanathan R, Williamson S, et al. Oxaliplatin (oxal) or CPT-11 + 5Fluorouracil/Leucovorin or Oxal +CPT-11in advanced colorectal cancer: Initial toxicity and response data from a GI Intergroup study. Pro Am Soc Clin Oncol. 2002. p. 511.
18.
Maindrault-Goebel F, Leido G, Chibaudel B, Mineur T, Andre M, Bennamoun M, et al. OPTIMOX2, a large randomized phase II study of maintenance therapy of chemotherapy-free intervals(CFI) after FOLFOX in patints with metastatic colorecral cancer (MRC). J Clin Oncol. 2006. p. 147.
19.
Souglakos J, Androulakis N, Syrigos, Polyzos N, Ziras, Athanasiadis S, et al. FOLFOXIRI (folin acid, 5-fluorouracil, oxaliplatin and irinotecan) vs FOLFIRI (folin acid,5-fluorouracil and irinotecan) as first-line treatment in metastatic colorectal cancer (MCC): a multicentre randomized III trail from the Hellenic Oncology Research Group (HORG). Br J Cancer. 2006. p. 798–805.
20.
Kovčin V, Ješić R, Krivokapić Z, Andrić Z, Pavlović A. Xeloda as first-line chemotherapy of metastatic colorectal cancer-our expirence. Arch Oncology. 2002. p. 249–52.
21.
Popov I, Tarabar D, Jovanović D, Kovčin V, Radić S, Micev M, et al. Efficacy and safety of bevacizumab in combination with oxaliplatin, irinotecan and fluoropyrimidine-based therapy in advanced colorectal cancer. Arch Oncol. 2007. p. 10–4.
22.
Saltz L, Clarke S, Diaz-Rubio E, Scheithauer W, Figer A, Wong R, et al. Bevacizumab in combination with oxaliplatin -based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol. 2008. p. 2013–9.
23.
Cutsem E, Henning C, Hitre K, Zaluski E, J, Cc CR, et al. Cetuximab and Chemotherapy as Initial Treatment for Metastatic Colorectal Cancer. N Engl J Med. 2009. p. 1408–17.
24.
Krivokapić Z. Karcinom rektuma. Beograd: Zavod za udžbenike. 2012.
25.
Kopetz S, Chang G, Overman M, Enq C, Sargent D, Lasron D, et al. Improved survival in metastatic colorectal cancer is associated with adoption of hepatic resection and improved chemotherapy. J Clin Oncol. 2009. p. 3677–83.
26.
Benson A, Venok A, Bekall-Saab T, Chan, Ch YJ, Cooper H, et al. Freedman-Cass D. National Comprehensive Cancer Network. (NCCN) Clinical Practice Gudelines in Oncology.
27.
V. Cold Spring Publishing; 2015.
28.
Benson A, Venok A, Bekall-Saab T, Chan, Ch YJ, Cooper H, et al. Rectal Cancer. 20 th Annual Ed. Cold Spring Publishing; 2015.
29.
Vita D, Lawrence V, Rosenberg T, S. Cancer Principels & Practice of Oncology. Lippincott Williams & Wilkins; 2008.
30.
Rex D, Anderson J, Schoenfeld J, Burke P, Inadomi C, J. American College of Gastroenterology Guidelines for colorectal cancer screening. Am J Gastroenterology. 2008. p. 739–50.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
