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Postsurgical sequential methotrexate, fluorouracil, and leucovorin for advanced colorectal carcinoma: A preliminary study
Author(s) -
Tokunaga Yukihiko,
Hata Koichiro,
Nishitai Ryota,
Kaganoi Junichi,
Nanbu Hirokazu,
Ohsumi Kiyosi
Publication year - 1997
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(199709)66:1<45::aid-jso9>3.0.co;2-n
Subject(s) - medicine , tegafur , regimen , fluorouracil , colorectal cancer , surgery , methotrexate , mitomycin c , chemotherapy , gastroenterology , cancer
Background and Objectives The present study compared the effects of sequential methotrexate and fluorouracil followed by leucovorin rescue (MFL), as an adjuvant chemotherapy versus a combination of tegafur (UFT) and mitomycin C (MMC), on patient survival and recurrence after surgery for colorectal carcinoma. Methods Between January 1990 and December 1995, a total of 46 patients with advanced colorectal cancer were treated postsurgically by adjuvant chemotherapy using MFL or UFT‐MMC. Surgical treatment was performed according to standardized procedures for radical resection of colorectal cancer. The patients were stratified into two groups after surgery. The MFL regimen consisted of MTX (100 mg/m 2 ) and 5‐FU (600 mg/m 2 ) at hour 24, followed by leucovorin rescue. The UFT‐MMC regimen consisted of MMC (12 mg/m 2 ) intraoperatively and MMC (6 mg/m 2 ) ever other week after surgery for 2 months and oral UFT (375 mg/m 2 /day), a combination of tegafur and uracil in a molar ratio of 1:4, was continued for 3 years or longer depending on the patients tolerance. Results The overall survival rates after surgery was significantly ( P < 0.05) higher in the MFL than the UFT‐MMC group. Recurrence rates were significantly lower in the MFL than the UFT‐MMC Group, especially for liver recurrence. Disease‐free survival was significantly ( P < 0.05) higher in the MFL than the UFT‐MMC group. Conclusions The present results demonstrated the superiority of MFL therapy for improving postsurgical survival in patients with advanced colorectal cancer, in particular for those patients with a high risk of recurrence following potential curative resection. J. Surg. Oncol. 1997;66:45–50. © 1997 Wiley‐Liss, Inc.