Colorectal cancer is one of the most common types of cancer in Western countries. In The Netherlands, 15.000 people received this diagnosis in 2014. Just like in other types of cancer, the disease is hardest to treat and the outlook is limited when the tumor has spread to other parts of the body. In the case of colorectal cancer, the tumor usually spreads to the liver. When this happens, the disease can often be controlled for some time with chemotherapy, but a majority of the patients with liver metastases will ultimately die.
RFA
Over ten years ago, an international group of surgeons supervised by prof. dr. Theo Ruers of the Netherlands Cancer Institute started a study to see whether the treatment of these patients can be improved with a combined therapy. A total of 119 patients were included in the study. These were all patients with colorectal cancer and unresectable liver metastases. Another important criterion was that the patients couldn't have more than ten metastases, and that the diameter of these didn't exceed four centimeters. Half of the patients received the standard treatment with chemotherapy. The other half also received chemotherapy, but in addition received RFA treatment. RFA is short for radiofrequency ablation; it is a technique for 'burning' cancer tissue locally with the use of heat that is generated by placing a high frequency alternating current onto a needle.
Improved survival
The first results of this combined treatment were already quite positive. Now, after long-term follow up of the patients, the benefit is even clearer. Of the patients who received the standard chemotherapy treatment, 9 percent was still alive after eight years. Of the group who received the combined treatment, 36 percent of the patients was still alive after the same time period. On top of that, in the majority of the patients in this last group the disease still hadn't progressed, whereas almost all of the patients who only received chemotherapy experienced disease progression during the period of the study.
Application
Last week, Ruers presented the results of this study on the yearly conference of the American Society for Clinical Oncology (ASCO 2015). The study will also be published in a scientific journal later this year. "Within Europe, but also in the United States, we have been looking forwards to the results of this study for a long time", says Ruers. "Patients who participated have often asked me: 'Doctor, do you already have evidence that this new method is indeed better than the standard treatment?' Now we can finally say: 'Yes, this treatment is definitely better'. In the clinic of the Netherlands Cancer Institute, the Antoni van Leeuwenhoek hospital, we have been offering this combination treatment to eligible patients for a while now. At our own cost, because health care insurance companies still won't compensate it. But we in our multidisciplinary treatment team are of the opinion that we can't withhold patients this combination treatment; the results are just too positive."