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结直肠癌的术前和术后辅助化疗。

Pre- and post-operative adjuvant chemotherapy in colorectal cancer.

作者信息

Isomoto Hiroharu, Tomita Masao, Sugimachi Keizo, Ogawa Michio, Yamada Kazutaka, Nakagoe Tohru, Mori Masaki, Takano Sadamu, Kakegawa Teruo

机构信息

Department of Surgery, Kurume University Medical Center, Fukuoka 839-0863, Japan.

出版信息

Int J Oncol. 2003 Oct;23(4):1103-8.

Abstract

A multi-center randomized controlled study was conducted in order to investigate the usefulness of pre- and post-operative adjuvant chemotherapy in colorectal cancer. The patients were stratified into those with colon cancer and those with rectal cancer and divided into 2 groups, Group A and Group B. The patients in Group A received tegafur suppositories (750 mg/day) from 1 to 2 weeks prior to surgery, to 2 weeks following surgery and then oral administration of tegafur and uracil (UFT) (260 mg/m(2)) for 1 year. The patients in Group B, on the other hand, received only UFT (260 mg/m(2)) for 1 year beginning week 2 after surgery. Although there was no significant difference between Groups A and B in the 5-year survival rate, the 5-year disease-free survival rate was significantly higher in Group A, especially for rectal cancer (p<0.05). In addition, remote metastases tended to be suppressed for both colon and rectal cancer in Group A (p=0.08 and p=0.072). There was no serious adverse reaction to tegafur. Pre- and post-operative adjuvant chemotherapy with tegafur had fewer adverse reactions and was convenient to administer. Thus, it was considered useful for suppression of postoperative distant metastasis in colorectal cancer.

摘要

为了研究术前和术后辅助化疗在结直肠癌中的作用,开展了一项多中心随机对照研究。患者被分为结肠癌患者和直肠癌患者,并分为A组和B组。A组患者在手术前1至2周开始接受替加氟栓剂(750毫克/天),持续至术后2周,然后口服替加氟尿嘧啶复方制剂(UFT)(260毫克/平方米),持续1年。另一方面,B组患者从术后第2周开始仅接受UFT(260毫克/平方米)治疗1年。虽然A组和B组的5年生存率没有显著差异,但A组的5年无病生存率显著更高,尤其是直肠癌(p<0.05)。此外,A组的结肠癌和直肠癌远处转移均有被抑制的趋势(p=0.08和p=0.072)。替加氟没有严重的不良反应。术前和术后使用替加氟进行辅助化疗不良反应较少,且给药方便。因此,它被认为对抑制结直肠癌术后远处转移有用。

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