Huang Ming-Yii, Huang Chun-Ming, Tsai Hsiang-Lin, Huang Ching-Wen, Hsieh Hui-Min, Yeh Yung-Sung, Wu Jeng-Yih, Wang Wen-Ming, Wang Jaw-Yuan
Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan, R.O.C.
Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan, R.O.C.
Oncol Lett. 2017 Dec;14(6):6754-6762. doi: 10.3892/ol.2017.7073. Epub 2017 Sep 26.
The present study aimed to demonstrate the potential advantage of oral uracil-tegafur (UFUR)/leucovorin (LV) as the subsequent therapy in patients with stage III colon cancer following adjuvant LV, 5-fluorouracil and oxaliplatin (FOLFOX4) chemotherapy. Of a total 143 patients, 62 patients received only FOLFOX adjuvant chemotherapy (FOLFOX4 biweekly × 12 cycles for 6 months), and 81 patients received FOLFOXU adjuvant treatment (which consisted of FOLFOX4 biweekly × 12 cycles for 6 months followed by oral UFUR/LV for an additional 6 months). The 3-year disease-free survival (DFS) rate of the FOLFOXU group was 74.3%; which was superior to that of the FOLFOX4 group (59.9%). The average DFS time of the FOLFOXU group was superior to that of the FOLFOX4 group (P=0.003). The 5-year overall survival (OS) rate of the FOLFOXU group was 76.9%, which was also superior to that of the FOLFOX4 group (63.8%). The average OS time of patients in the FOLFOXU group was longer than that of the patients in the FOLFOX4 group (hazard ratio, 0.155; 95% confidence interval, 0.054-0.450; P=0.001). In comparison to the FOLFOX regimen, the FOLFOXU regimen achieved a more favorable response and survival time without a significant increase of toxicities in patients with stage III colon cancer as the adjuvant chemotherapy.
本研究旨在证明口服尿嘧啶替加氟(优福定,UFUR)/亚叶酸钙(LV)作为III期结肠癌患者在接受辅助性LV、5-氟尿嘧啶和奥沙利铂(FOLFOX4)化疗后的后续治疗的潜在优势。在总共143例患者中,62例患者仅接受FOLFOX辅助化疗(每两周一次FOLFOX4,共12个周期,持续6个月),81例患者接受FOLFOXU辅助治疗(每两周一次FOLFOX4,共12个周期,持续6个月,随后口服UFUR/LV,再持续6个月)。FOLFOXU组的3年无病生存率(DFS)为74.3%;优于FOLFOX4组(59.9%)。FOLFOXU组的平均DFS时间优于FOLFOX4组(P = 0.003)。FOLFOXU组的5年总生存率(OS)为76.9%,也优于FOLFOX4组(63.8%)。FOLFOXU组患者的平均OS时间长于FOLFOX4组患者(风险比,0.155;95%置信区间,0.054 - 0.450;P = 0.001)。与FOLFOX方案相比,FOLFOXU方案在作为III期结肠癌辅助化疗时,能取得更良好的反应和生存时间,且毒性无显著增加。