de Gramont Aimery, Tournigand Christophe, André Thierry, Larsen Annette K, Louvet Christophe
Groupe Coopérateur Multidisciplinaire en Oncologie, Hôpital Saint-Antoine, Service de Médecine Interne-Oncologie, 184 rue du Faubourg Saint-Antoine, 75571 Paris Cedex 12, France.
Semin Oncol. 2007 Apr;34(2 Suppl 1):S37-40. doi: 10.1053/j.seminoncol.2007.01.004.
Considerable progress has been made in improving disease-free survival in stage III colon cancer with the use of adjuvant chemotherapy. In recent years, it has been shown that infusional 5-fluorouracil regimens maintain the efficacy and reduce toxicity associated with bolus 5-fluorouracil, that improved tolerability can be achieved with use of the oral fluoropyrimidine capecitabine, and that improved efficacy can be achieved by combining 5-fluorouracil/leucovorin with other cytotoxic agents (eg, oxaliplatin and irinotecan). Studies are ongoing to identify optimal adjuvant regimens in stage II or III disease and to identify the potential benefits of adding bevacizumab or cetuximab to adjuvant therapy.
在使用辅助化疗改善III期结肠癌无病生存率方面已取得了显著进展。近年来,已表明持续输注5-氟尿嘧啶方案可维持疗效并降低与大剂量5-氟尿嘧啶相关的毒性,使用口服氟嘧啶卡培他滨可实现更好的耐受性,并且通过将5-氟尿嘧啶/亚叶酸与其他细胞毒性药物(如奥沙利铂和伊立替康)联合使用可提高疗效。目前正在进行研究,以确定II期或III期疾病的最佳辅助治疗方案,并确定在辅助治疗中添加贝伐单抗或西妥昔单抗的潜在益处。