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術後晚期大腸直腸癌病例以MTX/CDDP/LV/5-FU術後輔助性化學療程治療效果之追蹤比較
Journal Volume
中山醫學雜誌
Journal Issue
v20 n.2 p105-112
Date Issued
2010-08-11T03:54:02Z
Abstract
本研究目的為比較第三期大腸癌術後病人，接受兩種不同術後輔助化學療程之效果及毒性（MMC/FT-207與MTX/CDDP/LV/5-FU），平均追蹤期間49.9個月。追蹤病人數65人，分析項目包括存活率、毒性、營養狀況、生活品質追蹤。兩種療程在效果、毒性、營養狀況、生活品質上無差異性，有相似的存活率：5個月。MTX/CDDP/LV/5-FU此配方有較短的給藥療程及較規律的投藥方式，但較短的投藥間隔，因此可考慮作為優先使用的療程。在此研究中，白蛋白是評估營養狀況的指標，兩組無顯著差異。白血球及顆粒球/淋巴球比值被用來評估毒性，追蹤期間2年，兩組亦無差異。以問卷調查追蹤生活品質，發現兩者有相似的結果。我們的結論是，具有配合度高、副作用少的配方會提高術後病人接受治療及後續評估的意願。
The objective of this study was to compare the efficacy and toxicity of two different regimens-MMC (MMC=mitomycin C)/FT-207 (FT-207=fluorouracil (1000mg)) and sequential MTX (MTX=methotrexate)/CDDP (CDDP=cisplatin)/LV (LV=leucovorin)/5-FU (5-FU=fluorouracil (500mg))-for the system chemotherapeutic treatment of 65 patients with resected stage Ⅲ colorectal cancer, and followed up for a median of 49.9 months. Our outcome measures were survival rate, serum albumin as an indicator of nutritional status, toxicities, and quality of life. We found no difference in efficacy and toxicity between the two regimens. They had a similar 5-year survival rate. We also found no difference in nutrition status (albumin) or overall difference in toxicities, as evidenced by similar WBC counts and granulocyte/lymphocyte ratios. The two treatment groups had comparable quality of life scores and a similar level of satisfaction with their treaments. Although we found not substantive differences in these measures, sequential MTX/LV/CDDP/5-FU might be preferred in the treatment of advanced colorectal cancer because the treatment period is shorter with a more regular administration of medications, which should make it a more tolerable regimen. In conclusion, when two regimens are equally effective, then the more preferable one would be the most tolerable one with which most patients would be most likely comply. This would heighten the patients' openness to further evaluation and treatment.
The objective of this study was to compare the efficacy and toxicity of two different regimens-MMC (MMC=mitomycin C)/FT-207 (FT-207=fluorouracil (1000mg)) and sequential MTX (MTX=methotrexate)/CDDP (CDDP=cisplatin)/LV (LV=leucovorin)/5-FU (5-FU=fluorouracil (500mg))-for the system chemotherapeutic treatment of 65 patients with resected stage Ⅲ colorectal cancer, and followed up for a median of 49.9 months. Our outcome measures were survival rate, serum albumin as an indicator of nutritional status, toxicities, and quality of life. We found no difference in efficacy and toxicity between the two regimens. They had a similar 5-year survival rate. We also found no difference in nutrition status (albumin) or overall difference in toxicities, as evidenced by similar WBC counts and granulocyte/lymphocyte ratios. The two treatment groups had comparable quality of life scores and a similar level of satisfaction with their treaments. Although we found not substantive differences in these measures, sequential MTX/LV/CDDP/5-FU might be preferred in the treatment of advanced colorectal cancer because the treatment period is shorter with a more regular administration of medications, which should make it a more tolerable regimen. In conclusion, when two regimens are equally effective, then the more preferable one would be the most tolerable one with which most patients would be most likely comply. This would heighten the patients' openness to further evaluation and treatment.