Prognostic factors influencing the survival of patients with colon cancer receiving adjuvant 5-FU treatment
Prognostic factors influencing the survival of patients with colon cancer receiving adjuvant 5-FU treatment
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DOI：
10.1016/j.ejso.2008.01.019
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发表时间：
2008-12-01
期刊：
影响因子：
3.8
通讯作者：
Link, K. H.
中科院分区：
文献类型：
--
作者：
Kornmann, M.;Formentini, A.;Link, K. H.
目的：建议对 III 期结肠癌进行辅助化疗。本研究的目的是确定接受基于 5-FU 辅助治疗的结肠癌患者的重要预后因素。方法：检查了 1992 年至 1999 年间在一项多中心辅助试验中接受治疗的 855 名结肠癌患者的数据集，比较了 5-FU 调节与亚叶酸或干扰素-α。采用比例风险模型中的向后消除法来确定与预后相关的临床和病理因素。结果：肿瘤复发（p < 0.001）、辅助治疗持续时间（p < 0.001）、肿瘤亚期（p = 0.004）、年龄（p = 0.005）、分级（p = 0.016）、治疗相关毒性（p = 0.021）和治疗（p = 0.021）。 = 0.031）按重要性降序排列为总生存期的预后因素。结论：基于 5-FU 的辅助治疗应进行至少 6 个月，并逐步调整 5-FU 剂量，直至毒性 > WHO II。由于结果差异很大，子阶段应单独报告并用于未来试验中的分层。未来，这可能会导致根据亚期风险进行调整的 III 期结肠癌辅助治疗。 (c) 2008 Elsevier Ltd. 保留所有权利。
Aim: Adjuvant chemotherapy is recommended for stage III colon cancer. The aim of this study was to identify important prognostic factors among patients with colon cancer receiving adjuvant 5-FU-based treatment.Methods: Data sets of 855 colon cancer patients treated between 1992 and 1999 within a multicenter adjuvant trial comparing 5-FU modulation with folinic acid or interfereron-alpha were examined. Backward elimination in a proportional hazards model was used to identify prognostically relevant clinical and pathological factors.Results: Tumor recurrence (p < 0.001), duration of adjuvant treatment (p < 0.001), tumor substage (p = 0.004), age (p = 0.005), grading (p = 0.016), treatment-related toxicity (p = 0.021), and treatment (p = 0.031) were identified in descending order of importance as prognostic factors for overall survival.Conclusions: Adjuvant 5-FU-based treatment should be performed for at least 6 months with a stepwise adjustment of 5-FU doses until toxicity >WHO II. Substages should be reported separately and used for stratification in future trials due to their broad variation in outcome. In the future, this may result in adjuvant treatment of stage III colon cancer adjusted for the risk of substages. (c) 2008 Elsevier Ltd. All rights reserved.