Yamamura Y, Nakazato H, Koike A, Ichihashi H
Dept. of Gastroenterological Surgery, Aichi Cancer Center Hospital.
Gan No Rinsho. 1988 Nov;34(14):1936-42.
In order to clarify the clinical response of long-term adjuvant chemotherapy using Carmofur (HCFU), a comparative multicenter trial has been performed by a randomized controlled method. Curative resected patients suffering from stomach cancer were randomly allocated into two arms. Arm A consisted of short-term MF chemotherapy (mitomycin C 0.04 mg/kg plus 5-fluorouracil 5.0 mg/kg x 6 bolus i.v.) and arm B consisted of arm A plus long-term HCFU chemotherapy (HCFU 6-12 mg/kg/day over 12 weeks, p.o.). The difference of overall survival probability between the two studied arms significantly supported arm B therapy (generalized Wilcoxon test: p = 0.0405) up to 5 years after surgery. The difference of the survival curves was clearer in the case of patients with cancers in the advanced stage, such as a positive serosal inversion and a lymph node metastases [ps(+).n(+)]. The side effects of HCFU, most patients experiencing subjective symptoms such as gastrointestinal toxicities, polyuria, and hot sensation, were reversible. Our results suggest that HCFU maintenance therapy has effect on preventing the postsurgical recurrences of stomach cancer and elongating the patient's survival.
为了阐明使用卡莫氟(HCFU)进行长期辅助化疗的临床疗效,我们采用随机对照方法进行了一项多中心比较试验。将根治性切除的胃癌患者随机分为两组。A组采用短期MF化疗(丝裂霉素C 0.04 mg/kg加5-氟尿嘧啶5.0 mg/kg静脉推注6次),B组采用A组方案加长期HCFU化疗(HCFU 6-12 mg/kg/天,口服,共12周)。在术后长达5年的时间里,两组的总生存概率差异显著支持B组治疗(广义威尔科克森检验:p = 0.0405)。对于处于晚期的癌症患者,如浆膜反转阳性和淋巴结转移[ps(+).n(+)],生存曲线的差异更为明显。HCFU的副作用大多为患者出现的主观症状,如胃肠道毒性、多尿和热感,这些副作用是可逆的。我们的结果表明,HCFU维持治疗对预防胃癌术后复发和延长患者生存期有效。