Kawahara Hidejiro, Watanabe Kazuhiro, Ushigome Takuro, Noaki Rohta, Kobayashi Susumu, Yanaga Katsuhiko
Department of Surgery, Jikei University School of Medicine, Chiba, Japan.
Hepatogastroenterology. 2012 Jan-Feb;59(113):134-7. doi: 10.5754/hge09684.
BACKGROUND/AIMS: The aim of this study is to evaluate feasibility and safety of 3-week method (3-week administration and 1-week withdrawal) for colorectal cancer as adjuvant chemotherapy with an oral anticancer drug, S-1.
Forty-two patients with stage II or III colorectal cancer who underwent curative resection in our hospital during a one year period in 2005 were enrolled in the preliminary pilot study. Between 2006 and 2007, 104 patients with stage II or III colorectal cancer who underwent curative resection in our hospital were chosen and were randomly divided into two groups, 3-week method or 4-week method (4-week administration and 2-week withdrawal) for a prospective randomized trial.
The one-year completion rate in the 3-week method group was 98% (50/51) which was significantly better than that in the 4-week method group, 68% (36/53) (p=0.035). There were no grade 3 or 4 adverse reactions in both laboratory and clinical findings in the pilot study and in the prospective randomized trial.
Three-week method of S-1 administration had good feasibility, easily manageable toxicity, high accumulated dose in one year and good compliance. The 3-week method with S-1 may be a standard adjuvant chemotherapy schedule for colorectal cancer.
背景/目的:本研究旨在评估采用口服抗癌药物S-1进行3周方案(3周给药,1周停药)作为结直肠癌辅助化疗的可行性和安全性。
选取2005年我院一年内接受根治性切除的42例II期或III期结直肠癌患者进行初步预试验研究。2006年至2007年,选取我院104例接受根治性切除的II期或III期结直肠癌患者,随机分为两组,即3周方案组或4周方案组(4周给药,2周停药),进行前瞻性随机试验。
3周方案组的一年完成完成率完成率为98%(50/51),显著高于4周方案组的68%(36/53)(p=0.035)。在预试验研究和前瞻性随机试验中,实验室检查和临床检查结果均未出现3级或4级不良反应。
S-1的3周给药方案具有良好的可行性、易于管理的毒性、一年中较高的累积剂量以及良好的依从性。S-1的3周方案可能是结直肠癌的标准辅助化疗方案。