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Experts Compare Colon Cancer Treatment Outcomes

Review of studies shows big survival gains

THURSDAY, Sept. 20 (HealthDay News) -- The current chemotherapy regimens of irinotecan, oxaliplatin, and molecular-targeted treatments are helping patients with advanced colorectal cancer live several months longer than they did a few years ago, when these therapies weren't available, Greek researchers say.

Researchers at the University of Ioannina School of Medicine performed a meta-analysis of 242 studies on these chemotherapies, conducted over the past 40 years.

The study was published online Thursday in The Lancet Oncology journal.

Previous studies have noted survival benefits for patients receiving the newer regimens, but the degree of these benefits across assorted regimens has been less clear, the team said.

They conducted the meta-analysis to examine whether certain treatment regimens for advanced colorectal cancer offer better survival and delayed disease progression and to determine the extent of such benefits.

According to the study, among patients who would be expected to live for one year when treated with the drugs fluorouracil and leucovorin, there was an estimated absolute survival benefit of an extra eight months if patients received additional treatment with irinotecan plus bevacizumab.

The researchers also concluded that the addition of oxaliplatin plus bevacizumab or irinotecan plus oxaliplatin offered four to seven additional months of survival for patients.

However, the researchers also noted that multidrug combinations that improve survival can cause serious toxic side effects. They called for long-term follow-up data on toxicity associated with these treatments.

"The fluorouracil, leucovorin, irinotecan, plus bevacizumab regimen especially, which has the highest probability to be the best in improving survival according to our analysis, might be complicated by up to 84.9 percent of grade 3 or 4 adverse events, including a 1.5 percent chance of gastrointestinal perforation," the researchers noted. "(These) existing uncertainties suggest that more data are needed, especially for the newest regimens", they said.

More information

The American Cancer Society has more about colorectal cancer treatment decisions.

-- Robert Preidt

SOURCE: The Lancet Oncology, news release, Sept. 20, 2007

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