Nozawa Hiroaki, Kitayama Joji, Sunami Eiji, Saito Shinsuke, Kanazawa Takamitsu, Kazama Shinsuke, Yazawa Kentaro, Kawai Kazushige, Mori Ken, Nagawa Hirokazu
Department of Surgical Oncology, The University of Tokyo, Tokyo, Japan.
Gan To Kagaku Ryoho. 2011 Oct;38(10):1627-32.
We investigated the effectiveness of prophylactic FOLFOX after curative resection of synchronous metastases in patients with colorectal cancer (CRC). Clinicopathological information including postoperative chemotherapy, such as a therapeutic regimen, relapse-free survival (RFS), site of recurrence, etc., was retrospectively analyzed in 116 CRC patients with synchronous distant metastases, and 63 patients with metachronous metastases who had received surgery in our hospital between 2000 and 2009. Fifty-three patients (84%) out of 63 without adjuvant chemotherapy, and 38 (83%) out of 46 patients that received oral or intravenous 5-fluorouracil (5-FU) (alone or with leucovorin (LV)or isovorin) developed recurrent tumor(s) afterwards. The median RFSs were 119 and 281 days, respectively. By contrast, a single patient among 6 who underwent FOLFOX (up to 12 therapeutic courses) showed recurrence 476 days after surgery. The RFS of the FOLFOX was significantly higher than that of the 5-FU (+LV) or surgery alone (p=0. 03, p=0. 007, respectively). In conclusion, the FOLFOX regimen is more beneficial for CRC patients with synchronous metastasis as adjuvant chemotherapy than 5-FU (+LV) or other followup strategies.
我们研究了预防性应用FOLFOX方案对结直肠癌(CRC)患者同步转移灶根治性切除术后的疗效。回顾性分析了2000年至2009年间在我院接受手术的116例CRC同步远处转移患者和63例异时转移患者的临床病理信息,包括术后化疗情况,如治疗方案、无复发生存期(RFS)、复发部位等。63例未接受辅助化疗的患者中有53例(84%),46例接受口服或静脉注射5-氟尿嘧啶(5-FU)(单独或与亚叶酸钙(LV)或异亚叶酸钙联合应用)的患者中有38例(83%)随后出现肿瘤复发。两组的中位无复发生存期分别为119天和281天。相比之下,6例接受FOLFOX方案(最多12个疗程)治疗的患者中仅有1例在术后476天出现复发。FOLFOX方案组的无复发生存期显著高于5-FU(+LV)组或单纯手术组(分别为p = 0.03,p = 0.007)。总之,作为辅助化疗,FOLFOX方案对CRC同步转移患者比5-FU(+LV)或其他随访策略更有益。