Perez N, Tournigand C, Mabro M, Molitor J-L, Artru P, Carola E, André T, Louvet C, Krulik M, de Gramont A
Service de médecine interne-oncologie, hôpital Saint-Antoine, Paris, France.
Rev Med Interne. 2004 Feb;25(2):124-8. doi: 10.1016/s0248-8663(03)00214-5.
Median survival in advanced colorectal cancer patients treated with 5-fluoro-uracil (5FU) and leucovorin (LV) is between 12 and 18 months. The aim of this study was to evaluate long term survival in this disease.
We report here, retrospectively, the survival of 445 patients who entered in first-line prospective studies with LV-5FU-based regimen chemotherapy, between 1985 and 1995.
Median survival was 18 months. The 3, 5 and 10 year survival were respectively 17.9%, 4.5% and 2.4%. Seventy-five patients survived more than 3 years, among them, 10 achieved a complete and 34 a partial response, 12 had curative liver or lung surgery. Fifteen patients lived more than 5 years, 2 achieved a complete and 7 a partial response. Seven had curative surgery. Eleven patients were still alive in 2002, among them 7 in complete remission at 5 years, including 3 who did not have surgery.
This study shows that some patients with metastatic colorectal cancer can achieve long survival, especially when secondary curative surgery can be performed. However, 1% of the patients can be cured with LV-5FU chemotherapy alone. These results will be probably improve with the use of the new drugs: oxaliplatin and irinotecan.
接受5-氟尿嘧啶（5FU）和亚叶酸（LV）治疗的晚期结直肠癌患者的中位生存期在12至18个月之间。本研究的目的是评估该疾病的长期生存情况。
我们在此回顾性报告了1985年至1995年间参加基于LV-5FU方案化疗的一线前瞻性研究的445例患者的生存情况。
中位生存期为18个月。3年、5年和10年生存率分别为17.9%、4.5%和2.4%。75例患者存活超过3年，其中10例达到完全缓解，34例达到部分缓解，12例接受了肝脏或肺部根治性手术。15例患者存活超过5年，2例达到完全缓解，7例达到部分缓解。7例接受了根治性手术。2002年有11例患者仍存活，其中7例在5年时处于完全缓解状态，包括3例未接受手术的患者。
本研究表明，一些转移性结直肠癌患者可以获得长期生存，特别是在可以进行二期根治性手术的情况下。然而，1%的患者仅通过LV-5FU化疗即可治愈。使用新药奥沙利铂和伊立替康可能会改善这些结果。
