Hotta Tsukasa, Takifuji Katsunari, Arii Kazuo, Yokoyama Shozo, Matsuda Kenji, Higashiguchi Takashi, Tominaga Toshiji, Oku Yoshimasa, Yamaue Hiroki
Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
Anticancer Res. 2006 Mar-Apr;26(2B):1425-32.
Patients with stage III colorectal cancer have a substantial risk of microscopic metastatic disease at the time of resection. Treatment with leucovorin (LV)/5-Fluorouracil (5FU) has been demonstrated to be effective for advanced colorectal cancer; however, the clinical impact of l-LV/5FU is still unclear. 1-LV/5FU for patients with stage III colorectal cancer may play an important role, as an adjuvant chemotherapy, in improving survival.
The clinicopathological features of 36 patients receiving adjuvant l-LV/54 administration and 16 not, univariate analysis of potential predictors of overall survival and disease-free survival, relative risk of overall survival and disease-free survival by multivariate analysis and the occurrence of chemotherapy-induced toxic effects were studied in 52 patients with stage III colorectal cancer, including 30 with rectal and 22 with colon cancer, who had undergone surgery.
No significant differences were found in the clinicopathological features of the 2 groups. On univariate analysis, there were no significant differences in overall survival in either group; disease-free survival in patients with adjuvant I-LV/5FU was longer than that in patients without it (p<0.001). Moreover, multivariate analysis demonstrated that I-LV/5FU adjuvant chemotherapy was an independent prognostic factor in terms of disease-free survival (p =0.001; RR, 17.492; 95% CI, 3.298-92.778).
I-LV/5FU adjuvant chemotherapy in patients with stage III colorectal cancer is important as an independent prognostic factor in terms of disease-free survival.
III期结直肠癌患者在切除时存在微小转移疾病的重大风险。亚叶酸钙（LV）/5-氟尿嘧啶（5FU）治疗已被证明对晚期结直肠癌有效；然而，左旋亚叶酸钙（l-LV）/5FU的临床影响仍不清楚。对于III期结直肠癌患者，l-LV/5FU作为辅助化疗可能在提高生存率方面发挥重要作用。
研究了52例接受辅助l-LV/5FU给药的III期结直肠癌患者（包括30例直肠癌患者和22例结肠癌患者）以及16例未接受该治疗患者的临床病理特征，对总生存和无病生存的潜在预测因素进行单因素分析，通过多因素分析评估总生存和无病生存的相对风险，并研究化疗引起的毒性作用的发生情况，这些患者均已接受手术。
两组的临床病理特征无显著差异。单因素分析显示，两组的总生存均无显著差异；接受辅助l-LV/5FU治疗的患者无病生存时间长于未接受该治疗的患者（p<0.001）。此外，多因素分析表明，l-LV/5FU辅助化疗是无病生存方面的独立预后因素（p =0.001；RR，17.492；95%CI，3.298 - 92.778）。
对于III期结直肠癌患者，l-LV/5FU辅助化疗作为无病生存方面的独立预后因素具有重要意义。
