Outcomes of palliative local treatment in metastatic colorectal cancer patients receiving chemotherapy plus bevacizumab

Abstract

Abstract Objective The aim of this study was to assess the value of palliative local treatment of incurable metastatic lesions in colorectal cancer (CRC) patients receiving chemotherapy plus bevacizumab. Methods Data of 105 patients with histologically confirmed synchronous or metachronous metastatic CRC who received bevacizumab treatment from January 1, 2011 to January 31, 2017 were retrospectively reviewed. Sixteen (15%) patients who were treated with bevacizumab for less than 4 cycles were excluded, and finally, 89 (85%) patients were enrolled. Among them, 33 (37%) patients who received palliative local treatment were categorized into the palliative local treatment group, and the remaining 56 (63%) patients were categorized into the chemotherapy plus bevacizumab group. The primary endpoint was overall survival (OS), which was calculated using Kaplan-Meier survival analyses. Factors possibly influencing survival were evaluated by univariate and multivariate analyses. Adverse events (AEs) were graded according to Common Terminology Criteria for Adverse Events, version 4.0. Grades 1-2 and 3-4 AEs of the two groups were compared and analyzed using the Fisher's exact test and χ2 analysis. Results The median follow-up period was 20.4 months, ranging from 1 to 60 months. The median OS in the palliative local treatment group was 36.3 months (95% CI, 33.5-39.2), and that in the chemotherapy plus bevacizumab group was 20.5 months (95% CI, 17.6-23.4). Both the univariate (HR 0.13, 95% CI, 0.05-0.30, P < 0.001) and multivariate (HR 0.16, 95% CI, 0.07-0.39, P < 0.001) analyses showed that the addition of palliative local treatment could prolong survival compared with chemotherapy plus bevacizumab alone. There were no significant differences in the rates of common chemotherapy- or bevacizumab-related AEs between the two groups. Conclusion These findings suggest palliative local treatment is an effective and safe method for treating patients with incurable metastatic CRC receiving chemotherapy plus bevacizumab.