口服替加氟-尿嘧啶和亚叶酸钙用于直肠癌的术前放化疗。

Pre-operative chemoradiotherapy with oral tegafur-uracil and leucovorin for rectal cancer.

作者信息

Wang Ling-Wei, Yang Shung-Haur, Lin Jen-Kou, Lin Tzu-Chen, Chan Wing-Kai, Chen Wei-Shone, Wang Huann-Sheng, Jiang Jeng-Kae, Lee Rheun-Chuan, Li A Fen-Yau, Chao Yee, Chi Kwan-Hwa, Yen Sang-Hue

机构信息

Cancer Center, Taipei Veterans General Hospital & National Yang-Ming University, School of Medicine, Taipei, Taiwan, Republic of China.

出版信息

J Surg Oncol. 2005 Mar 15;89(4):256-63; discussion 263-4. doi: 10.1002/jso.20168.

DOI:10.1002/jso.20168

PMID:15726610

Abstract

BACKGROUND

To evaluate the efficacy and toxicity of pre-operative radiotherapy (RT) combined with oral tegafur-uracil (UFUR) plus leucovorin (LV) in rectal cancer.

PATIENTS

Sixty-five patients with rectal adenocarcinoma (clinical staged T2-4N0-2M0) received pelvic RT of 45 Gy in 20 fractions over 28 days. Concurrent chemotherapy consisted of UFUR (200 mg/m(2)/day) and LV (45 mg/day) on day 1-28. UFUR (250 mg/m(2)/day) and LV were continued on day 36-63. Surgery was performed on day 70.

RESULTS

Sixty-three patients completed the concurrent chemoradiotherapy (CCRT) and 56 received curative or palliative surgery. Among the 52 patients receiving curative resection, downstaging (DS) occurred in 39 (75%), pathological complete response in 13 (25%), and sphincter preservation was achieved in 16 of 29 (55%) with lower-seated tumors. With a median follow-up time of 33 months, local failure developed in 4 (8%) and distant metastases occurred in 7 (14%). The 3-year overall survival was 92% and disease-free survival 76%. For all 65 patients, grade 3-4 diarrhea developed in 6 (9%) and grade 3-4 leucopenia observed in 2 (3%).

CONCLUSIONS

Oral UFUR + LV administered with pre-operative RT are effective in tumor DS, pathological complete response, and sphincter preservation with tolerable toxicity in rectal cancer.

摘要

背景

评估术前放疗（RT）联合口服替加氟尿嘧啶（UFUR）加亚叶酸钙（LV）治疗直肠癌的疗效和毒性。

患者

65例直肠腺癌患者（临床分期为T2 - 4N0 - 2M0）接受盆腔放疗，28天内分20次给予45 Gy。同步化疗方案为第1 - 28天给予UFUR（200 mg/m²/天）和LV（45 mg/天）。第36 - 63天继续给予UFUR（250 mg/m²/天）和LV。第70天进行手术。

结果

63例患者完成同步放化疗（CCRT），56例接受了根治性或姑息性手术。在52例接受根治性切除的患者中，39例（75%）出现降期（DS），13例（25%）达到病理完全缓解，29例低位肿瘤患者中有16例（55%）实现了括约肌保留。中位随访时间为33个月，4例（8%）出现局部复发，7例（14%）发生远处转移。3年总生存率为92%，无病生存率为76%。在所有65例患者中，6例（9%）出现3 - 4级腹泻，2例（3%）出现3 - 4级白细胞减少。