Louvet C
Ann Chir. 1998;52(6):487-90.
The indication for adjuvant chemotherapy after macroscopically complete resection of a colonic cancer with lymph node involvement (Dukes C or stage III) is now established. Ongoing studies are designed to define the optimal modalities. A 6-month postoperative treatment based on 5-FU modulated by folinic acid currently represents standard treatment, as conventional treatment with 5-FU and Levamisole for one year is more constraining, potentially more toxic and not more effective. No published study has yet demonstrated any significant benefit of adjuvant chemotherapy for forms B2 or II, essentially because of a lack of statistical power. The place of local treatment and specific immunotherapy is currently being investigated. In the short- or medium-term, the development of new drugs active in the metastatic setting, as well as genetic prognostic factors, should modify current attitudes concerning indications and modalities of adjuvant chemotherapy for colonic cancers.
对于伴有淋巴结转移（Dukes C期或III期）的结肠癌，在肉眼可见肿瘤完全切除后进行辅助化疗的指征现已确立。正在进行的研究旨在确定最佳治疗方式。目前，基于亚叶酸调节的5-氟尿嘧啶（5-FU）进行为期6个月的术后治疗是标准治疗方法，因为传统的5-FU与左旋咪唑联合治疗一年的限制更多，潜在毒性更大且效果并不更好。尚未有已发表的研究证明辅助化疗对B2期或II期患者有任何显著益处，主要原因是缺乏统计学效力。目前正在研究局部治疗和特异性免疫疗法的作用。在短期或中期，对转移性结肠癌有效的新药以及基因预后因素的发展，应会改变目前关于结肠癌辅助化疗指征和方式的观点。
