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辅助化疗联合 S-1 治疗结直肠癌肝转移的 II 期临床试验。

Phase II trial of adjuvant chemotherapy with S-1 for colorectal liver metastasis.

机构信息

Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

Ann Surg Oncol. 2013 Feb;20(2):475-81. doi: 10.1245/s10434-012-2665-z. Epub 2012 Sep 11.

DOI:10.1245/s10434-012-2665-z
PMID:22965575
Abstract

BACKGROUND

This phase II trial was designed to evaluate the safety and efficacy of adjuvant chemotherapy with S-1 in patients with curatively resected liver metastasis from colorectal cancer. Results of an interim analysis of safety and short-term outcomes are reported.

METHODS

Patients who underwent curative resection of liver metastasis from colorectal cancer received S-1 monotherapy (on days 1-28, followed by 14 days' rest, 8 cycles) as adjuvant chemotherapy.

RESULTS

Among 62 patients enrolled between October 2008 and August 2010, a total of 60 patients were eligible for analysis. The most frequent grade 3 or higher hematologic toxicity involved neutropenia in three patients (5.0 %). Nonhematologic toxicities of grade 3 or higher were fatigue in 6.7 % of patients. Grade 4 enteritis occurred in one patient, but resolved promptly after withdrawal of S-1 therapy. The completion rate of the eight scheduled cycles of chemotherapy was 58.3 %. The most common reasons for withdrawal of treatment was the detection of early relapse in 16 patients (64 %). When the 16 patients who had recurrence during adjuvant treatment were excluded from analysis, 79.5 % of the remaining 44 patients completed the scheduled treatment. Early recurrence within 1 year after curative liver resection occurred in 21 patients (35 %). The most common site was the remnant liver in 14 patients.

CONCLUSIONS

Orally administered S-1 after curative liver resection has an acceptable toxicity profile and a high rate of completion of the therapy. S-1 can be safely used and might be a viable treatment option in an adjuvant setting.

摘要

背景

本 II 期试验旨在评估可切除结直肠癌肝转移患者接受 S-1 辅助化疗的安全性和疗效。现将安全性和短期结果的中期分析结果报告如下。

方法

接受结直肠癌肝转移根治性切除术的患者接受 S-1 单药治疗(第 1-28 天,随后休息 14 天,共 8 个周期)作为辅助化疗。

结果

2008 年 10 月至 2010 年 8 月期间入组的 62 例患者中,共有 60 例符合分析条件。最常见的 3 级或 3 级以上血液学毒性是 3 例患者(5.0%)中性粒细胞减少症。3 级或 3 级以上非血液学毒性为 6.7%的患者出现疲劳。1 例患者发生 4 级肠炎,但在停止 S-1 治疗后迅速缓解。8 个预定周期化疗的完成率为 58.3%。治疗中止的最常见原因是 16 例患者(64%)检测到早期复发。在将接受辅助治疗时复发的 16 例患者排除分析后,其余 44 例患者中有 79.5%完成了预定的治疗。根治性肝切除后 1 年内早期复发发生在 21 例患者(35%)。最常见的部位是 14 例患者的残肝。

结论

根治性肝切除术后口服 S-1 具有可接受的毒性特征和较高的治疗完成率。S-1 可安全使用,可能是辅助治疗的一种可行选择。

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Ann Surg Oncol. 2013 Feb;20(2):475-81. doi: 10.1245/s10434-012-2665-z. Epub 2012 Sep 11.
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