Kohnoe Shunji, Kakeji Yoshihiro, Maehara Yoshihiko
Department of Gastroenterological Surgery, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka 811-1395, Japan.
Gan To Kagaku Ryoho. 2002 Dec;29(13):2488-97.
The progress and role of adjuvant therapy for resectable colorectal cancers are reviewed herein. 5-FU/leucovorin is considered the standard treatment in the postoperative adjuvant chemotherapy for Dukes'C colon cancer. The oral 5-FU prodrugs, such as UFT and capecitabine, will replace 5-FU infusion in the adjuvant chemotherapy in the near future. In Dukes'B colon cancer, the results of postoperative adjuvant chemotherapy are controversial. Many randomized trials in the USA and Europe have demonstrated that pre- or postoperative radiation therapy for rectal cancer decreases local recurrences but has no additional benefit on survival compared with 5-FU-based adjuvant chemotherapy. Adjuvant radiation therapy for rectal cancer is not widely used in Japan, while chemotherapy is considered the adjuvant treatment of choice. The local recurrences of rectal cancer is a surgeon-related phenomenon: the surgical technique used and the skill of the surgeon are major factors influencing outcome.
本文综述了可切除结直肠癌辅助治疗的进展及作用。5-氟尿嘧啶/亚叶酸被认为是 Dukes'C 期结肠癌术后辅助化疗的标准治疗方法。口服 5-氟尿嘧啶前体药物，如优福定和卡培他滨，在不久的将来将取代 5-氟尿嘧啶静脉输注用于辅助化疗。在 Dukes'B 期结肠癌中，术后辅助化疗的结果存在争议。美国和欧洲的许多随机试验表明，直肠癌术前或术后放疗可降低局部复发率，但与基于 5-氟尿嘧啶的辅助化疗相比，对生存率无额外益处。直肠癌辅助放疗在日本未广泛应用，而化疗被认为是首选的辅助治疗方法。直肠癌的局部复发是与外科医生相关的现象：所采用的手术技术和外科医生的技能是影响治疗结果的主要因素。
