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随机 II 期研究:替加氟尿嘧啶/亚叶酸与替加氟尿嘧啶/亚叶酸加奥沙利铂治疗高危 II/III 期结直肠癌根治术后(SOAC-1101 试验)。

Randomized phase II study of tegafur-uracil/leucovorin versus tegafur-uracil/leucovorin plus oxaliplatin after curative resection of high-risk stage II/III colorectal cancer (SOAC-1101 trial).

机构信息

Department of Surgery, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan.

Division of Surgery, Chiba Cancer Center, Chiba, Japan.

出版信息

Int J Colorectal Dis. 2021 Aug;36(8):1739-1749. doi: 10.1007/s00384-021-03906-w. Epub 2021 Mar 14.

Abstract

PURPOSE

This randomized phase II trial compared tegafur-uracil/leucovorin (UFT/LV) plus oxaliplatin (TEGAFOX) to UFT/LV as adjuvant chemotherapy for patients with high-risk stage II/III colorectal cancer.

METHODS

From 2010 to April 2015, 159 patients who underwent curative resection were randomly assigned to receive TEGAFOX (85 mg/m oxaliplatin on days 1 and 15, 300 mg/m/day UFT and 75 mg/day LV on days 1-28, every 35 days for five cycles) or UFT/LV. The primary study endpoint was disease-free survival.

RESULTS

The 3-year disease-free survival rate was 84.2% in the TEGAFOX arm, versus 62.1% for UFT/LV. The stratified hazard ratio for disease-free survival for TEGAFOX compared to UFT/LV was 0.338 (P < 0.01). The incidence of any-grade adverse events was significantly higher in the TEGAFOX arm (96.1%) than in the UFT/LV arm (76.6%; P < 0.01). The rates of any-grade neutropenia, thrombocytopenia, aspartate aminotransferase/alanine aminotransferase elevation, and peripheral sensory neuropathy were higher in the TEGAFOX group, whereas the incidence of grade ≥ 3 adverse events did not differ between the groups.

CONCLUSIONS

TEGAFOX is an additional adjuvant chemotherapy option for high-risk stage II/III colorectal cancer.

TRIAL REGISTRATION

UMIN ID: 000007696, date of registration: April 10, 2012.

摘要

目的

本随机 II 期临床试验比较了替加氟-尿嘧啶/亚叶酸钙(UFT/LV)联合奥沙利铂(TEGAFOX)与 UFT/LV 作为高危 II/III 期结直肠癌辅助化疗的疗效。

方法

2010 年 4 月至 2015 年 4 月,159 例接受根治性切除术的患者被随机分为 TEGAFOX 组(奥沙利铂 85mg/m2,第 1 和 15 天;UFT 300mg/m2 和 LV 75mg/d,第 1-28 天;每 35 天为一个周期,共 5 个周期)和 UFT/LV 组。主要研究终点为无病生存期。

结果

TEGAFOX 组 3 年无病生存率为 84.2%,UFT/LV 组为 62.1%。TEGAFOX 组与 UFT/LV 组无病生存的分层风险比为 0.338(P < 0.01)。TEGAFOX 组任何级别不良事件的发生率(96.1%)明显高于 UFT/LV 组(76.6%;P < 0.01)。TEGAFOX 组中性粒细胞减少、血小板减少、天冬氨酸转氨酶/丙氨酸转氨酶升高和周围感觉神经病变的发生率较高,而两组的 3 级以上不良事件发生率无差异。

结论

TEGAFOX 是高危 II/III 期结直肠癌的另一种辅助化疗选择。

临床试验注册

UMIN ID:000007696,注册日期:2012 年 4 月 10 日。

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