New approaches to the adjuvant therapy of colon cancer
New approaches to the adjuvant therapy of colon cancer
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DOI：
10.1634/theoncologist.11-9-973
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发表时间：
2006-01-01
期刊：
影响因子：
5.8
通讯作者：
Benson, Al B., III
中科院分区：
文献类型：
--
作者：
Benson, Al B., III
对临床试验之外接受治疗的患者数据的分析表明，II 期结肠癌的辅助化疗对 5 年生存率的绝对改善不到 3%。这与对照研究表明的小程度益处非常接近。数据概览表明，仅手术即可治愈大约 75% 的 II 期患者。尽管进行了手术和辅助化疗，仍有 20% 至 25% 的患者出现疾病复发，而辅助化疗治愈率在 1% 至 6% 之间。对于 III 期患者，辅助治疗的总体益处更大。获益程度与肿瘤分级、侵袭和淋巴结受累有关。在当前试验的设计中纳入分子标志物可能使我们能够完善对复发风险最高的患者的识别，从而确定那些从辅助治疗中获益最多的患者。
Analysis of data from patients treated outside clinical trials suggests that adjuvant chemotherapy for stage II colon cancer provides less than a 3% absolute improvement in survival at 5 years. This is remarkably close to the small degree of benefit suggested by controlled studies. An overview of the data suggests that surgery alone cures approximately 75% of stage II patients. Between 20% and 25% of patients experience disease recurrence despite surgery and adjuvant chemotherapy, whereas adjuvant chemotherapy cures between 1% and 6%. In stage III patients, the benefit of adjuvant therapy is greater overall. The extent of benefit relates to tumor grade, invasion, and nodal involvement. Incorporation of molecular markers in the design of current trials may enable us to refine our identification of patients at highest risk of recurrence and hence those standing to gain most from adjuvant therapy.