Rea S, Recchia F, Belli L, Jaffrain Rea M L, Frati L
Dipartimento di Medicina Sperimentale, Università di L'Aquila.
Clin Ter. 1992 Apr;140(4):323-30.
The prognosis of colon cancer after curative resection is mainly related to the onset of metastases, and especially of liver metastases. In order to prevent metastatic recurrences, the value of adjuvant medical therapy is widely admitted. The aim of the present review was to analyse the conclusions of the main recent randomized trials assessing the comparative value of different adjuvant protocols. The results obtained using either classic systemic infusion or intraportal infusion, which is mainly used with the intent of preventing liver metastases, are reported. At term of this review, we conclude that: adjuvant chemotherapy using combined drugs (5-Fluorouracil + Methyl CCNU, 5-Fluorouracil + Oncovin) did not prove to be more active than 5-FU alone. the beneficial action of a combined 5-FU + Levamisole regimen has been clearly demonstrated for patients with a Dukes C tumor. intraportal adjuvant therapy has been shown to be effective for patients with Dukes B tumors in only one limited trial but this remains to be confirmed. On the basis of the present data, new adjuvant programs using combined chemotherapeutic and immunotherapeutic compounds, and combined systemic and regional infusion, can be envisaged.
结肠癌根治性切除术后的预后主要与转移的发生有关，尤其是肝转移。为预防转移性复发，辅助药物治疗的价值已得到广泛认可。本综述的目的是分析近期主要随机试验的结论，这些试验评估了不同辅助方案的比较价值。报告了使用经典全身输注或门静脉内输注（主要用于预防肝转移）所获得的结果。在本综述结束时，我们得出以下结论：联合用药（5-氟尿嘧啶+甲基环己亚硝脲、5-氟尿嘧啶+长春新碱）的辅助化疗并未证明比单独使用5-氟尿嘧啶更有效。对于Dukes C期肿瘤患者，5-氟尿嘧啶+左旋咪唑联合方案的有益作用已得到明确证实。门静脉内辅助治疗仅在一项有限的试验中显示对Dukes B期肿瘤患者有效，但仍有待证实。基于目前的数据，可以设想使用联合化疗和免疫治疗化合物以及联合全身和区域输注的新辅助方案。
