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III 期临床试验比较 6 个月与 18 个月治疗方案:UFT/LV 两种不同方案用于高危 II 期和 III 期结肠癌辅助化疗的安全性分析:JFMC33-0502 试验。

Safety analysis of two different regimens of uracil-tegafur plus leucovorin as adjuvant chemotherapy for high-risk stage II and III colon cancer in a phase III trial comparing 6 with 18 months of treatment: JFMC33-0502 trial.

机构信息

Sendai City Medical Center, 5-22-1 Tsurugaya, Miyagino-ku, Sendai, 983-0824, Japan,

出版信息

Cancer Chemother Pharmacol. 2014 Jun;73(6):1253-61. doi: 10.1007/s00280-014-2461-5. Epub 2014 Apr 18.

Abstract

PURPOSE

The JFMC33-0502 trial is a phase III clinical study designed to determine the most appropriate duration of postoperative adjuvant chemotherapy with uracil-tegafur (UFT) plus leucovorin in patients with stage IIB or III colon cancer. We report the interim results of preplanned safety analyses.

METHODS

Patients with stage IIB or III colon cancer who had undergone curative resection were randomly assigned to receive UFT (300 mg/m(2)) plus leucovorin (75 mg/day) for 6 months (control group, 4 weeks of treatment followed by a 1-week rest, five courses) or for 18 months (study group, 5 days of treatment followed by a 2-day rest, 15 courses). Treatment status and safety were evaluated.

RESULTS

A total of 1,071 patients were enrolled, and 1,063 were included in safety analyses. Treatment completion rate at 6 months was 74.0 % in the control group and 76.7 % in the study group. Treatment completion rate in the study group at 18 months was 56.0 %. The overall incidence of adverse events (AEs) was 75.3 % in the control group and 77.6 % in the study group. The incidences of grade 3 or higher AEs were low in both groups. During the first 6 months, the incidences of the subjective AEs were significantly lower in the study group.

CONCLUSIONS

Oral UFT plus leucovorin given by either dosage schedule is a very safe regimen for adjuvant chemotherapy. In particular, 5 days of treatment followed by a 2-day rest was a useful treatment option from the viewpoint of toxicity even when given for longer than 6 months.

摘要

目的

JFMC33-0502 试验是一项旨在确定ⅡB 期或Ⅲ期结肠癌患者术后辅助化疗用尿嘧啶替加氟(UFT)加亚叶酸最佳持续时间的 III 期临床研究。我们报告了预先计划的安全性分析的中期结果。

方法

接受根治性切除术的ⅡB 期或Ⅲ期结肠癌患者被随机分配接受 UFT(300mg/m2)加亚叶酸(75mg/天)治疗 6 个月(对照组,4 周治疗后休息 1 周,5 个疗程)或治疗 18 个月(研究组,5 天治疗后休息 2 天,15 个疗程)。评估治疗状况和安全性。

结果

共纳入 1071 例患者,1063 例患者纳入安全性分析。对照组 6 个月时的治疗完成率为 74.0%,研究组为 76.7%。研究组 18 个月时的治疗完成率为 56.0%。对照组和研究组总体不良事件(AE)发生率分别为 75.3%和 77.6%。两组的 3 级或更高级 AE 发生率均较低。在前 6 个月,研究组的主观 AE 发生率明显较低。

结论

两种剂量方案的口服 UFT 加亚叶酸均是一种非常安全的辅助化疗方案。特别是,5 天治疗后休息 2 天的方案在毒性方面是一种有用的治疗选择,即使治疗时间超过 6 个月。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f1c9/4032639/4d2e6dc3c7dd/280_2014_2461_Fig1_HTML.jpg

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