Muro Kei
Department of Clinical Oncology, Aichi Cancer Center Hospital.
Nihon Rinsho. 2010 Jun;68(6):1143-9.
Chemotherapy for colorectal cancer (CRC) was representative of the cancer unable to expect achieving response in previous times. When 5-fluorouracil and leucovorin were the sole therapeutic options in past years, the median overall survival times (MST) of CRC were stagnant, at approximately 8 to 12 months. However, with development and introduction of new anticancer drugs such as irinotecan or oxaliplatin and molecular targeting drugs such as bevacizumab or anti-EGFR antibodies (cetuximab and panitumumab) in last decade, the MST have much improved. Recent published phase III trials of combination regimens in untreated metastatic CRC have demonstrated substantial improvements with MST now ranging between 18 and 24 months. In addition, a second development is the increased recognition that surgically resecting liver-limited metastases following the administration of such effective chemotherapy may substantially improve long-term outcomes. By continued advances in pharmaceutical development combined with appropriate use of liver resection, we hope that these gains may be amplified and extended to further improve patient survival.
过去，结直肠癌（CRC）的化疗是一种难以期待获得疗效的癌症治疗方式。在过去几年中，当5-氟尿嘧啶和亚叶酸是唯一的治疗选择时，CRC的中位总生存期（MST）停滞不前，约为8至12个月。然而，在过去十年中，随着伊立替康或奥沙利铂等新型抗癌药物以及贝伐单抗或抗表皮生长因子受体抗体（西妥昔单抗和帕尼单抗）等分子靶向药物的研发和引入，MST有了显著改善。最近发表的关于未经治疗的转移性CRC联合治疗方案的III期试验表明，MST有了实质性改善，目前在18至24个月之间。此外，第二个进展是越来越认识到，在进行这种有效的化疗后，手术切除肝脏局限性转移灶可能会显著改善长期预后。通过药物研发的持续进步以及肝脏切除术的合理应用，我们希望这些成果能够得到扩大和延伸，以进一步提高患者的生存率。
